Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 00874 | Date 01/09/2018 |
| Token No | SM/18-19/1135 01/09/2018 | Serial | 009 Last Visit: 01/09/2018 |
| Patient Name | Baby SUPROBHA MONDAL | Contact No | |
| Address | 53 /A MUKHARJEE PARA LANE | Age | 4.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15/A KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||