Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06430 | Date 16/09/2019 |
| Token No | SM/19-20/10482 16/09/2019 | Serial | 083 Last Visit: 16/09/2019 |
| Patient Name | Miss SUPARNA SANTRA | Contact No | 8512951703 |
| Address | 18 N.N RAY STREET SERAMPORE | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||