Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06695 | Date 19/10/2019 |
| Token No | SM/19-20/12077 19/10/2019 | Serial | 026 Last Visit: 19/10/2019 |
| Patient Name | Miss SNEHA GHOSH | Contact No | 8420883382 |
| Address | 144/4 CHATRA MUKHERJEE PARA HARISABHA , BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||