Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05816 | Date 17/07/2019 |
| Token No | SM/19-20/6715 17/07/2019 | Serial | 087 Last Visit: 17/07/2019 |
| Patient Name | Miss SREEJITA PAL | Contact No | 8292326068 |
| Address | 201 TELIPARA,BAGER BAGAN,BAIDYABATI(M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||