Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02736 | Date 29/12/2018 |
| Token No | SM/18-19/5970 29/12/2018 | Serial | 025 Last Visit: 29/12/2018 |
| Patient Name | Baby MRIGANKITA | Contact No | 9051106228 |
| Address | 39N GT ROAD CHATRA ,BAIDYABATI (M) | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||