Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06819 | Date 07/11/2019 |
| Token No | SM/19-20/13582 19/11/2019 | Serial | 079 Last Visit: 27/02/2020 |
| Patient Name | Miss SAMPA DAS | Contact No | 9330374084 |
| Address | 103 TELIPARA CHATRA , BAIDYABATI(M) | Age | 9 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||