Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03922 | Date 28/02/2019 |
| Token No | SM/19-20/3322 24/05/2019 | Serial | 007 Last Visit: 27/09/2019 |
| Patient Name | Miss KABERI DAS | Contact No | 8697161183 |
| Address | 53(22) CHATRA PATI PARA,BAIDYABATI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||