Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02988 | Date 14/01/2019 |
| Token No | SM/18-19/6753 14/01/2019 | Serial | 044 Last Visit: 14/01/2019 |
| Patient Name | Miss PRITI MAJUMDAR | Contact No | 9831194007 |
| Address | VIVEKANAND SARANI | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||