Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04783 | Date 20/04/2019 |
| Token No | SM/19-20/2181 04/05/2019 | Serial | 041 Last Visit: 04/05/2019 |
| Patient Name | Miss ISHA GANGPUTRA | Contact No | 8481841790 |
| Address | 41 A.P. GHOSH ROAD | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||