Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 03092 | Date 19/01/2019 |
| Token No | SM/18-19/7103 19/01/2019 | Serial | 036 Last Visit: 14/12/2019 |
| Patient Name | Baby NANDANI DAS | Contact No | 7449505411 |
| Address | 11/36 BAISANB PARA LANE, SERAMPORE | Age | 4.8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||