Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02543 | Date 15/12/2018 |
| Token No | SM/18-19/5281 15/12/2018 | Serial | 013 Last Visit: 15/12/2018 |
| Patient Name | Miss SASTIKA SARKAR | Contact No | 8617735204 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI (M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||