Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04478 | Date 30/03/2019 |
| Token No | SM/18-19/11624 30/03/2019 | Serial | 039 Last Visit: 30/03/2019 |
| Patient Name | Miss NEHA DAS | Contact No | 9903134834 |
| Address | 101 N.S AVENUE SERAMPORE | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||