Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04325 | Date 20/03/2019 |
| Token No | SM/18-19/10965 20/03/2019 | Serial | 070 Last Visit: 20/03/2019 |
| Patient Name | Miss RIMPA MONDAL | Contact No | 8910800697 |
| Address | 1 CHATRA BARUI PARA SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||