Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02641 | Date 21/12/2018 |
| Token No | SM/19-20/7943 05/08/2019 | Serial | 082 Last Visit: 05/08/2019 |
| Patient Name | Miss ISHITA KORA | Contact No | 6289303978 |
| Address | 57 G/A J T ROAD,BAIDYABATI(M) | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||