Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03144 | Date 22/01/2019 |
| Token No | SM/19-20/7048 22/07/2019 | Serial | 066 Last Visit: 23/09/2021 |
| Patient Name | Baby SAMSITA HALDAR | Contact No | 8820450756 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 2 Y 8 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||