Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03263 | Date 31/01/2019 |
| Token No | SM/19-20/21750 30/04/2020 | Serial | 034 Last Visit: 09/06/2021 |
| Patient Name | Miss SUITI DAS | Contact No | 8617269014 |
| Address | 20/11 KALI TALA LANE, BAIDYABATI(M) | Age | 9.5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||