Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04273 | Date 18/03/2019 |
| Token No | SM/18-19/10730 18/03/2019 | Serial | 029 Last Visit: 18/03/2019 |
| Patient Name | Baby NIRMALYA BHUIYA | Contact No | 9339062793 |
| Address | 4 PROF. KKM SARANI CHATRA SERAMPORE | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||