Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06746 | Date 23/10/2019 |
| Token No | SM/19-20/12292 23/10/2019 | Serial | 030 Last Visit: 23/10/2019 |
| Patient Name | Miss DIPTI GANGPUTRA | Contact No | 9088872765 |
| Address | 41 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||