Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05145 | Date 16/05/2019 |
| Token No | SM/19-20/2893 16/05/2019 | Serial | 055 Last Visit: 16/05/2019 |
| Patient Name | Baby DEETYA BANERJEE | Contact No | 7842691024 |
| Address | 59 DUTTA PARA LANE SERAMPORE | Age | 4 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 5.68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||