Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05750 | Date 13/07/2019 |
| Token No | SM/19-20/9201 27/08/2019 | Serial | 009 Last Visit: 27/08/2019 |
| Patient Name | Miss ANKITA DAS | Contact No | 9088609969 |
| Address | 52/A SATCHASI PARA,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 | |||