Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03286 | Date 01/02/2019 |
| Token No | SM/18-19/9553 27/02/2019 | Serial | 042 Last Visit: 27/02/2019 |
| Patient Name | Miss GURI KHATUN | Contact No | 9546968138 |
| Address | 34 SHILBAGAN,SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||