Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06848 | Date 13/11/2019 |
| Token No | SM/19-20/13146 13/11/2019 | Serial | 073 Last Visit: 13/11/2019 |
| Patient Name | Miss DONA MONDAL | Contact No | 7890214339 |
| Address | 59/D G.T ROAD TENTULTALA HANUMANMANDIR , BAIDYABATI(M) | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||