Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04447 | Date 28/03/2019 |
| Token No | SM/18-19/11466 28/03/2019 | Serial | 068 Last Visit: 28/03/2019 |
| Patient Name | Miss RUPSA MONDAL | Contact No | 9681052559 |
| Address | 40/2 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||