Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03605 | Date 16/02/2019 |
| Token No | SM/18-19/8777 16/02/2019 | Serial | 001 Last Visit: 16/02/2019 |
| Patient Name | Baby RISHIKA MONDOL | Contact No | 7890399392 |
| Address | CHATRA BAGHER BAGAN,TELI PARA,BAIDYABATI(M) | Age | 1 T 10 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||