Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08276 | Date 22/05/2020 |
| Token No | SM/19-20/22400 22/05/2020 | Serial | 010 Last Visit: 22/05/2020 |
| Patient Name | Miss MALA DAS | Contact No | 9330991205 |
| Address | 8 KANAI DEWAN TALA BYE LANE SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||