Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01134 | Date 14/09/2018 |
| Token No | SM/18-19/1755 18/09/2018 | Serial | 021 Last Visit: 05/08/2019 |
| Patient Name | Baby MEGHALA SHEET | Contact No | 7044767913 |
| Address | 96, SHIBTALA BYE LANE , BAIDYABATI (M) | Age | 3.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||