Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05439 | Date 14/06/2019 |
| Token No | SM/19-20/4611 14/06/2019 | Serial | 086 Last Visit: 14/06/2019 |
| Patient Name | Miss ANY DEBNATH | Contact No | 9635973069 |
| Address | 2 KOLONI,RAJJODARPUR | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||