Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03087 | Date 19/01/2019 |
| Token No | SM/18-19/7093 19/01/2019 | Serial | 026 Last Visit: 19/01/2019 |
| Patient Name | Baby SUPARNA BISWAS | Contact No | 8582880303 |
| Address | 108/2 CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||