Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03926 | Date 01/03/2019 |
| Token No | SM/18-19/9647 01/03/2019 | Serial | 022 Last Visit: 01/03/2019 |
| Patient Name | Miss SAUMILI ROY | Contact No | 8583090971 |
| Address | 43/B PRABASH NAGER | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||