Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06885 | Date 16/11/2019 |
| Token No | SM/19-20/13366 16/11/2019 | Serial | 026 Last Visit: 16/11/2019 |
| Patient Name | Baby SHERYA RAM | Contact No | |
| Address | RAMKRISHNA ROAD BAIDYABATI(M) | Age | 4.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||