Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02927 | Date 09/01/2019 |
| Token No | SM/18-19/6561 09/01/2019 | Serial | 050 Last Visit: 09/01/2019 |
| Patient Name | Miss PAYAL KORMOKAR | Contact No | 7278025421 |
| Address | 25 CHAKERBORTY LANE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||