Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04290 | Date 18/03/2019 |
| Token No | SM/18-19/10793 18/03/2019 | Serial | 092 Last Visit: 18/03/2019 |
| Patient Name | Miss MAHIMA KHATUN | Contact No | 6290525218 |
| Address | 63 N.N ROY STREET SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||