Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04392 | Date 26/03/2019 |
| Token No | SM/19-20/3449 27/05/2019 | Serial | 005 Last Visit: 14/02/2020 |
| Patient Name | Miss SUBHRA DAS | Contact No | 9804700130 |
| Address | 3, HARIJAN ROAD , BAIDYABATI(M) | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||