Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03223 | Date 29/01/2019 |
| Token No | SM/18-19/7553 29/01/2019 | Serial | 046 Last Visit: 29/01/2019 |
| Patient Name | Baby DIYA SARKAR | Contact No | 9088925456 |
| Address | NOGAMOR, BIADYABATI(M) | Age | 2.10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||