Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08193 | Date 01/05/2020 |
| Token No | SM/19-20/21814 01/05/2020 | Serial | 020 Last Visit: 01/05/2020 |
| Patient Name | Miss SUMANA MONDAL | Contact No | 8336953436 |
| Address | 31/A BARA BAGAN LANE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||