Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03911 | Date 28/02/2019 |
| Token No | SM/18-19/9603 28/02/2019 | Serial | 025 Last Visit: 28/02/2019 |
| Patient Name | Mrs. PIU HALDER | Contact No | 8017389491 |
| Address | BAGHER BAGAN,TELIPARA,BAIDYABATI(M) | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||