Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07387 | Date 21/01/2020 |
| Token No | SM/19-20/16995 21/01/2020 | Serial | 039 Last Visit: 21/01/2020 |
| Patient Name | Miss FARAT PARVEEN | Contact No | 6290008522 |
| Address | 107/C G T ROAD,BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||