Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05031 | Date 07/05/2019 |
| Token No | SM/19-20/2307 07/05/2019 | Serial | 088 Last Visit: 11/05/2019 |
| Patient Name | Miss SANIA DEY | Contact No | 9674357914 |
| Address | MAHIYARI ANDUL ANDUL MOURI HAORA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||