Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06367 | Date 11/09/2019 |
| Token No | SM/19-20/10101 11/09/2019 | Serial | 008 Last Visit: 11/09/2019 |
| Patient Name | Miss SUSHMITA DAS | Contact No | 9836702922 |
| Address | 26 CHATRA DUTTA PARA SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||