Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06918 | Date 19/11/2019 |
| Token No | SM/19-20/13577 19/11/2019 | Serial | 074 Last Visit: 19/11/2019 |
| Patient Name | Baby RUHI SEN | Contact No | |
| Address | RAMKRISHNA ROAD , BAIDYABATI(M) | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||