Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05184 | Date 21/05/2019 |
| Token No | SM/19-20/3151 21/05/2019 | Serial | 099 Last Visit: 21/05/2019 |
| Patient Name | Miss PALLABI CHAKRABORTY | Contact No | 8697421914 |
| Address | BOROBAGAN ,SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||