Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06818 | Date 07/11/2019 |
| Token No | SM/19-20/12891 07/11/2019 | Serial | 062 Last Visit: 27/02/2020 |
| Patient Name | Miss TUMPA DAS | Contact No | 9330374084 |
| Address | 103 TELIPARA CHATRA , BAIDYABATI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||