Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06608 | Date 12/10/2019 |
| Token No | SM/19-20/11592 12/10/2019 | Serial | 007 Last Visit: 24/06/2020 |
| Patient Name | Miss MALOBIKA PAUL | Contact No | 9748122278 |
| Address | 217 (81/J) G.T ROAD BAGER BAGAN , BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||