Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03009 | Date 15/01/2019 |
| Token No | SM/18-19/9009 19/02/2019 | Serial | 039 Last Visit: 11/05/2019 |
| Patient Name | Baby SNEHA DAS | Contact No | 9804922977 |
| Address | BAHIR SERAMPORE, KALITALA | Age | 3.3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||