Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03994 | Date 05/03/2019 |
| Token No | SM/19-20/15448 16/12/2019 | Serial | 112 Last Visit: 16/12/2019 |
| Patient Name | Miss PAYEL SHAW | Contact No | 7890225796 |
| Address | 10/K LAHIRI STREET CHATRA SERAMPORE | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||