Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07146 | Date 14/12/2019 |
| Token No | SM/19-20/15253 14/12/2019 | Serial | 018 Last Visit: 14/12/2019 |
| Patient Name | Miss ANKITA KHANRA | Contact No | 9836134576 |
| Address | 34/18A GHOSAL PARA NABOGRAM , BAIDYABATI(M) | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||