Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04589 | Date 06/04/2019 |
| Token No | SM/19-20/10249 12/09/2019 | Serial | 067 Last Visit: 12/09/2019 |
| Patient Name | Miss MOHOR INDRA | Contact No | 9674474286 |
| Address | 22 HARISH BYE LANE , BAIDYABATI(M) | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||