Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01261 | Date 22/09/2018 |
| Token No | SM/19-20/6248 10/07/2019 | Serial | 116 Last Visit: 03/02/2020 |
| Patient Name | Mrs. SANGITA HALDAR | Contact No | 9674039044 |
| Address | CHATRA BAGHER BAGAN | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||