Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05000 | Date 02/05/2019 |
| Token No | SM/19-20/2086 02/05/2019 | Serial | 057 Last Visit: 19/08/2020 |
| Patient Name | Miss SWARMISTA SANTRA | Contact No | 7551867383 |
| Address | 18 N.N RAY STREET SERAMPORE | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||