Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08469 | Date 02/07/2020 |
| Token No | SM/19-20/23667 02/07/2020 | Serial | 076 Last Visit: 02/07/2020 |
| Patient Name | Miss PIYALI DAS | Contact No | 7595905127 |
| Address | 31/A BARA BAGAN LANE | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||