Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07058 | Date 03/12/2019 |
| Token No | SM/19-20/14594 03/12/2019 | Serial | 077 Last Visit: 24/02/2020 |
| Patient Name | Miss JINIYA SETT | Contact No | 9088950234 |
| Address | 16 N.C LANE CHATRA BAIDYABATI(M) | Age | 1 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||