Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08443 | Date 29/06/2020 |
| Token No | SM/19-20/23508 29/06/2020 | Serial | 016 Last Visit: 28/07/2020 |
| Patient Name | Baby ARFIA KHATOON | Contact No | 9007712385 |
| Address | 20NO KANAI DEOWANTALA LANE SERAMPORE M | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||