Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05610 | Date 28/06/2019 |
| Token No | SM/19-20/5527 28/06/2019 | Serial | 031 Last Visit: 28/06/2019 |
| Patient Name | Miss SUBHOSREE JANA | Contact No | 9046495855 |
| Address | CHATRA SETALA TALA,BAIDYABATI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||