Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03899 | Date 27/02/2019 |
| Token No | SM/18-19/9563 27/02/2019 | Serial | 052 Last Visit: 26/11/2019 |
| Patient Name | Miss SHILPA MAJHI | Contact No | 8420962913 |
| Address | 362/A GT ROAD PAN PARA , BAIDYABATI(M) | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||