Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00134 | Date 04/08/2018 |
| Token No | SM/18-19/384 11/08/2018 | Serial | 016 Last Visit: 18/08/2018 |
| Patient Name | Baby SANKITA DAS | Contact No | |
| Address | 68, G.T ROAD , SERAMPORE | Age | 4.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||