Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02548 | Date 15/12/2018 |
| Token No | SM/18-19/5310 15/12/2018 | Serial | 042 Last Visit: 15/12/2018 |
| Patient Name | Miss NAZRA PRAWEEN | Contact No | 8479021537 |
| Address | 5 , PARSI LANE SERAMPORE | Age | 13 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||