Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07076 | Date 05/12/2019 |
| Token No | SM/19-20/18878 28/02/2020 | Serial | 064 Last Visit: 14/03/2020 |
| Patient Name | Baby KOYEL BOSE | Contact No | 9674027539 |
| Address | 80 BARUI PARA LANE CHATRA SERAMPORE | Age | 14 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||