Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06292 | Date 31/08/2019 |
| Token No | SM/19-20/9567 31/08/2019 | Serial | 048 Last Visit: 31/08/2019 |
| Patient Name | Miss ASTUMI NANDI | Contact No | 9163676463 |
| Address | 63/23A HARIJAN ROAD CHATRA DAS PARA , BAIDYABATI(M) | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||