Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02996 | Date 14/01/2019 |
| Token No | SM/18-19/6783 14/01/2019 | Serial | 074 Last Visit: 14/01/2019 |
| Patient Name | Miss RINA KHATUN | Contact No | 9123624709 |
| Address | NASIB PUR, HOOGHLY | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||