Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05396 | Date 12/06/2019 |
| Token No | SM/19-20/6050 08/07/2019 | Serial | 023 Last Visit: 08/07/2019 |
| Patient Name | Miss SNEHA DAS | Contact No | 9836681070 |
| Address | 51/3 RAMKRISHNA ROAD , BAIDYABATI(M) | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||