Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05931 | Date 24/07/2019 |
| Token No | SM/19-20/7210 24/07/2019 | Serial | 052 Last Visit: 24/07/2019 |
| Patient Name | Miss SOMA DAS | Contact No | 9062932050 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||