Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01889 | Date 05/11/2018 |
| Token No | SM/19-20/8098 07/08/2019 | Serial | 041 Last Visit: 06/04/2020 |
| Patient Name | Miss SRIJITA CHAKRABORTY | Contact No | 8240926718 |
| Address | 48//298 BIDHANPALLY,BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||