Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04399 | Date 26/03/2019 |
| Token No | SM/18-19/11251 26/03/2019 | Serial | 044 Last Visit: 26/03/2019 |
| Patient Name | Baby PIHU BURNWAL | Contact No | 8981490952 |
| Address | CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 11 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 6.98 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||