Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06427 | Date 16/09/2019 |
| Token No | SM/19-20/10472 16/09/2019 | Serial | 073 Last Visit: 16/09/2019 |
| Patient Name | Miss SOUMILI PAL | Contact No | 8443008719 |
| Address | 13/A KUMOR PARA CHATRA SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||