Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06583 | Date 30/09/2019 |
| Token No | SM/19-20/11335 30/09/2019 | Serial | 008 Last Visit: 30/09/2019 |
| Patient Name | Miss NATASHA RAJAK | Contact No | 9875349664 |
| Address | 237 BAURI PARA,BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||