Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03766 | Date 21/02/2019 |
| Token No | SM/18-19/9190 21/02/2019 | Serial | 052 Last Visit: 21/02/2019 |
| Patient Name | Miss SATHI MAJHI | Contact No | 8981187836 |
| Address | 23/A CHATRA GODAR BAGAN BY LANE, BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||