Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05209 | Date 23/05/2019 |
| Token No | SM/19-20/19576 13/03/2020 | Serial | 050 Last Visit: 13/03/2020 |
| Patient Name | Miss SHRUTI DAS | Contact No | 9804700130 |
| Address | CHATRA LANKAR BAGAN TETULTALA SERAMPORE HOOGHLY | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||