Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07402 | Date 22/01/2020 |
| Token No | SM/19-20/17056 22/01/2020 | Serial | 037 Last Visit: 22/01/2020 |
| Patient Name | Miss SAHIN KHATOON | Contact No | 8444979212 |
| Address | 7 ARBINDA SARANI SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||