Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07247 | Date 28/12/2019 |
| Token No | SM/19-20/16011 28/12/2019 | Serial | 049 Last Visit: 28/12/2019 |
| Patient Name | Miss SARNYA PAL | Contact No | 8443988413 |
| Address | 12 KAJIPARA PANIHATI NEAR SANTOSHI MATA MANDIR PANIHATI(M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||