Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02203 | Date 29/11/2018 |
| Token No | SM/18-19/4364 29/11/2018 | Serial | 025 Last Visit: 29/11/2018 |
| Patient Name | Miss BARSHA RAJBHAR | Contact No | 8820041790 |
| Address | 27, BAJAR BY LANE SERAMPORE TINBAJAR | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||