Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00761 | Date 28/08/2018 |
| Token No | SM/19-20/18457 20/02/2020 | Serial | 049 Last Visit: 20/02/2020 |
| Patient Name | Miss TULIKA DEY | Contact No | 9339596943 |
| Address | 301I/B CHATRA TELI PARA , BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||