Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06433 | Date 16/09/2019 |
| Token No | SM/19-20/10495 16/09/2019 | Serial | 096 Last Visit: 16/09/2019 |
| Patient Name | Miss MOHUA PATRA | Contact No | 9804704256 |
| Address | 134/A N.S AVENUE SERAMPORE | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||