Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03003 | Date 14/01/2019 |
| Token No | SM/18-19/6797 14/01/2019 | Serial | 088 Last Visit: 14/01/2019 |
| Patient Name | Miss PRYANKA DAS | Contact No | 8961285337 |
| Address | 1/13 CHATRA BAGHER BAGAN,BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||