Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04567 | Date 05/04/2019 |
| Token No | SM/19-20/327 05/04/2019 | Serial | 033 Last Visit: 05/04/2019 |
| Patient Name | Miss AINDRILA PAUL | Contact No | 9831342357 |
| Address | 269/D/A GHOSAL PARA LANE, NABAGRAM SERAMPORE, BAIDYABATI(M | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||