Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06189 | Date 21/08/2019 |
| Token No | SM/19-20/8876 21/08/2019 | Serial | 038 Last Visit: 21/08/2019 |
| Patient Name | Miss SABITA PAL | Contact No | 9330220109 |
| Address | 209/G TELIPARA CHATRA , BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||