Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05113 | Date 15/05/2019 |
| Token No | SM/19-20/2791 15/05/2019 | Serial | 031 Last Visit: 15/05/2019 |
| Patient Name | Baby ANANYA DAS | Contact No | 9163109461 |
| Address | 17 PNK BANERJEE LANE CHATRA GARGARI GHAT SERAMPORE | Age | 11 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 7 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||