Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06458 | Date 18/09/2019 |
| Token No | SM/19-20/10602 18/09/2019 | Serial | 023 Last Visit: 25/11/2019 |
| Patient Name | Miss MAHIMA SHAW | Contact No | 8481947521 |
| Address | 14/A PGB SARANI SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||