Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03434 | Date 07/02/2019 |
| Token No | SM/19-20/3708 30/05/2019 | Serial | 001 Last Visit: 11/06/2019 |
| Patient Name | Miss ANKITA BASHU | Contact No | 7595858286 |
| Address | CHATRA,BAGHER BAGAN,TELI PARA,BAIDYABATI(M) | Age | 8 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||