Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03591 | Date 15/02/2019 |
| Token No | SM/19-20/22289 16/05/2020 | Serial | 005 Last Visit: 16/05/2020 |
| Patient Name | Baby HASIBA KHATUN | Contact No | 7431098096 |
| Address | BOROBELUR KALTALA, MILKI BADAMTALA SERAMPORE | Age | 2.6 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||