Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04063 | Date 07/03/2019 |
| Token No | SM/19-20/17669 05/02/2020 | Serial | 045 Last Visit: 05/02/2020 |
| Patient Name | Miss SOHANA KHATUN | Contact No | 7685001718 |
| Address | PAMPA NAGAR CHATRA , BAIDYABTI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||