Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05182 | Date 21/05/2019 |
| Token No | SM/19-20/3125 21/05/2019 | Serial | 073 Last Visit: 21/05/2019 |
| Patient Name | Miss UMA RANI KARMAKAR | Contact No | 7278064122 |
| Address | 190/2 RAJYADHAR PUR GOVT COLONY SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||