Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03284 | Date 01/02/2019 |
| Token No | SM/18-19/7771 01/02/2019 | Serial | 047 Last Visit: 01/02/2019 |
| Patient Name | Miss ANISHA KOLEY | Contact No | 9674111420 |
| Address | CHATRA SHITALA TALA,BAIDYABATY(M) | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||