Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02107 | Date 24/11/2018 |
| Token No | SM/18-19/4095 24/11/2018 | Serial | 025 Last Visit: 24/11/2018 |
| Patient Name | Miss MOUMI CHAKRABORTY | Contact No | 9874932621 |
| Address | PRABHASH NAGAR | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||