Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06466 | Date 19/09/2019 |
| Token No | SM/19-20/10664 19/09/2019 | Serial | 046 Last Visit: 19/09/2019 |
| Patient Name | Miss SHEYOSREE DAS | Contact No | 9123009096 |
| Address | NABOGRAM SADOGH PARA ,BAIDYABATI(M) | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||