Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01628 | Date 07/02/2019 |
| Token No | SM/18-19/2370 07/02/2019 | Serial | 011 |
| Patient Name | Baby SOUMILI KUNDU | Contact No | 9748461778 |
| Address | 33 PANDIT KALINATH BHATTACHATRJEE STREET | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||