Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02355 | Date 05/12/2018 |
| Token No | SM/18-19/4727 05/12/2018 | Serial | 051 Last Visit: 05/12/2018 |
| Patient Name | Baby SERSTHA DUTTA | Contact No | 7686003350 |
| Address | CHATRA DUTTA PARA | Age | 1 Y 4 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 8 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||