Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05983 | Date 29/07/2019 |
| Token No | SM/19-20/7477 29/07/2019 | Serial | 013 Last Visit: 05/05/2020 |
| Patient Name | Miss RAJNI SHAW | Contact No | 8420694601 |
| Address | 307/79 RAM KRISHNA ROAD CHATRA , BAIDYABTI(M) | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||