Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03051 | Date 17/01/2019 |
| Token No | SM/18-19/6979 17/01/2019 | Serial | 059 Last Visit: 27/03/2019 |
| Patient Name | Miss OLIVIYA DEY | Contact No | 8910039232 |
| Address | 132 N.S AVENUE SERAMPORE | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||