Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06920 | Date 19/11/2019 |
| Token No | SM/19-20/13580 19/11/2019 | Serial | 077 Last Visit: 19/11/2019 |
| Patient Name | Baby SUMAN ROY | Contact No | |
| Address | RAMKRISHNA ROAD , BAIDYABATI(M) | Age | 4.2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||