Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05535 | Date 24/06/2019 |
| Token No | SM/19-20/5155 24/06/2019 | Serial | 021 Last Visit: 24/06/2019 |
| Patient Name | Baby SURJO DOLUI | Contact No | 9836371149 |
| Address | SEORAPHULY,KANAI, DOL TALA,BAIDYABATI(M) | Age | 3Y 6M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||