Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04287 | Date 18/03/2019 |
| Token No | SM/18-19/11071 23/03/2019 | Serial | 075 Last Visit: 23/03/2019 |
| Patient Name | Miss AARTI KOIRI | Contact No | 6290162335 |
| Address | 50 MUKHERJEE PARA LANE SERAMPORE | Age | 5.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||