Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09224 | Date 28/01/2021 |
| Token No | SM/20-21/29857 28/01/2021 | Serial | 036 Last Visit: 28/01/2021 |
| Patient Name | Miss ANITA PATRA | Contact No | 8478995639 |
| Address | 320/486 G T ROAD CHATRA SERAMPORE, BAIDYABATI(M) | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||