Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02285 | Date 03/12/2018 |
| Token No | SM/18-19/4538 03/12/2018 | Serial | 004 Last Visit: 04/02/2019 |
| Patient Name | Miss ANUSHKA MALLICK | Contact No | 9051998385 |
| Address | CHANDANAGAR | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||