Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02051 | Date 20/11/2018 |
| Token No | SM/18-19/3944 20/11/2018 | Serial | 022 Last Visit: 20/11/2018 |
| Patient Name | Baby KOYEL POLLEY | Contact No | |
| Address | 17, CHAKRABORTY PARA | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||