Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00983 | Date 07/09/2018 |
| Token No | SM/18-19/1359 07/09/2018 | Serial | 031 Last Visit: 25/10/2021 |
| Patient Name | Miss BIPASA PAL | Contact No | 8017570530 |
| Address | 10 CHATRA BAZAR ROAD SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||