Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02635 | Date 21/12/2018 |
| Token No | SM/18-19/5855 27/12/2018 | Serial | 113 Last Visit: 17/05/2019 |
| Patient Name | Baby BABUSONA HALDER | Contact No | 9062573106 |
| Address | TETULTALA,BAGER BAGAN,BAIDYABATI(M) | Age | 9 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||