Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06445 | Date 17/09/2019 |
| Token No | SM/19-20/10542 17/09/2019 | Serial | 033 Last Visit: 05/06/2020 |
| Patient Name | Miss NAFISA KHATOON | Contact No | 6289266469 |
| Address | 9 MUSALMAN PARA CHATRA , SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||