Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03538 | Date 13/02/2019 |
| Token No | SM/18-19/8557 13/02/2019 | Serial | 024 Last Visit: 13/02/2019 |
| Patient Name | Miss RITAMA MAITY | Contact No | 8420796911 |
| Address | 19 CHATRA MUKHERJEE PARA,HARISABHA,BAIDYABATI(M) | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||