Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05813 | Date 17/07/2019 |
| Token No | SM/20-21/27046 02/11/2020 | Serial | 041 Last Visit: 21/01/2021 |
| Patient Name | Miss SHREEJANI DAS | Contact No | 9163681165 |
| Address | 212 TELIPARA,BAGER BAGAN,BAIDYABATI(M) | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||