Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04524 | Date 03/04/2019 |
| Token No | SM/19-20/150 03/04/2019 | Serial | 005 Last Visit: 30/11/2019 |
| Patient Name | Miss SANGITA NATH | Contact No | 6290498966 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 6.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||