Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02905 | Date 08/01/2019 |
| Token No | SM/18-19/6498 08/01/2019 | Serial | 052 Last Visit: 08/01/2019 |
| Patient Name | Miss TRISHA PAUL | Contact No | 7059441022 |
| Address | 146/362 G T ROAD ,CHATRA BOUBAZAR,BAIDYABATY(M) | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||