Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04047 | Date 06/03/2019 |
| Token No | SM/18-19/10955 20/03/2019 | Serial | 060 Last Visit: 29/04/2023 |
| Patient Name | Miss SUSMITA DAS | Contact No | 9836702922 |
| Address | 301/T/N G T ROAD BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||