Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03669 | Date 18/02/2019 |
| Token No | SM/18-19/8933 18/02/2019 | Serial | 106 Last Visit: 18/02/2019 |
| Patient Name | Miss BANASHRITA MALIK | Contact No | 9681230435 |
| Address | 189/47 SHITALA TALA ROAD CHATRA , BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||