Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00759 | Date 28/08/2018 |
| Token No | SM/18-19/939 28/08/2018 | Serial | 009 Last Visit: 28/08/2018 |
| Patient Name | Baby RASHI PAL | Contact No | 8981219165 |
| Address | 16, RAJA K.L GOSWAMI STREET | Age | 5.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||