Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08039 | Date 07/04/2020 |
| Token No | SM/19-20/20863 07/04/2020 | Serial | 041 Last Visit: 07/04/2020 |
| Patient Name | Baby SUMONA ROY | Contact No | 8478869219 |
| Address | 10/A/Z/V/F/C/B G T ROAD PAMPA NAGAR CHATRA BAIDYABATI M | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||