Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03514 | Date 12/02/2019 |
| Token No | SM/18-19/8483 12/02/2019 | Serial | 087 Last Visit: 12/02/2019 |
| Patient Name | Baby SAYANTIKA CHATERJEE | Contact No | |
| Address | 73/M BAGER BAGAN BAIDYABATI(M) | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||