Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06770 | Date 31/10/2019 |
| Token No | SM/19-20/12525 31/10/2019 | Serial | 046 Last Visit: 31/10/2019 |
| Patient Name | Baby RISHA RAY | Contact No | 9748069284 |
| Address | CHOTO BELUR CHECK POST, SERAMPORE (PANCHAYAT) | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||