Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06857 | Date 14/11/2019 |
| Token No | SM/19-20/13212 14/11/2019 | Serial | 039 Last Visit: 14/11/2019 |
| Patient Name | Miss PAYEL MONDAL | Contact No | 6291964990 |
| Address | 232 CHARABAGAN BAUREPARA, BAIDYBATI(M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||