Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03152 | Date 24/01/2019 |
| Token No | SM/19-20/1566 24/04/2019 | Serial | 036 Last Visit: 24/04/2019 |
| Patient Name | Miss SUBHOSREE DUTTA | Contact No | 9239143288 |
| Address | 47/B CHATRA BARUI PARA LANE | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||