Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02222 | Date 29/11/2018 |
| Token No | SM/18-19/9786 02/03/2019 | Serial | 105 Last Visit: 23/09/2021 |
| Patient Name | Miss BARSHA HALDER | Contact No | 8820450756 |
| Address | CHATRA BAGHER BAGAN,BAIDAYABATI(M) | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||