Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 01823 | Date 01/11/2018 |
| Token No | SM/18-19/3273 01/11/2018 | Serial | 022 Last Visit: 01/11/2018 |
| Patient Name | Miss AYANTIKA MANNA | Contact No | 9330809948 |
| Address | 171 G.T ROAD SHEWRAPHULI, BAIDYABATI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||