Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09326 | Date 15/03/2021 |
| Token No | SM/20-21/30750 15/03/2021 | Serial | 062 Last Visit: 15/03/2021 |
| Patient Name | Miss PRITIKA DAS | Contact No | 7044742483 |
| Address | 32A/A G.T. ROAD,NABAGRAM,BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||