Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06767 | Date 31/10/2019 |
| Token No | SM/19-20/12513 31/10/2019 | Serial | 034 Last Visit: 31/10/2019 |
| Patient Name | Miss SONALI RAY | Contact No | 8478869219 |
| Address | CHATRA PAMPA NAGAR,BAIDYABTI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||