Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09933 | Date 12/08/2021 |
| Token No | SM/21-22/9004 17/01/2022 | Serial | 020 Last Visit: 17/01/2022 |
| Patient Name | Baby ANKUSH DHARA | Contact No | 9836352755 |
| Address | CHATRA DAKKHIN BHATTACHARJI PARA. | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||