Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06261 | Date 29/08/2019 |
| Token No | SM/19-20/12201 22/10/2019 | Serial | 024 Last Visit: 01/04/2020 |
| Patient Name | Miss PUJA GHOSH | Contact No | 9062141548 |
| Address | GOURNAI, KHAMERGACHI HOOGHLY | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||