Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02486 | Date 12/12/2018 |
| Token No | SM/18-19/5482 19/12/2018 | Serial | 046 Last Visit: 06/06/2019 |
| Patient Name | Miss ANANYA DUTTA | Contact No | 9830934789 |
| Address | 30/A DOCTOR BAGAN LANE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||