Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05039 | Date 08/05/2019 |
| Token No | SM/19-20/3201 22/05/2019 | Serial | 042 Last Visit: 22/05/2019 |
| Patient Name | Miss MOU DAS | Contact No | 9062082615 |
| Address | PAHALAMPUR P.S- SINGUR, DIST- HOOGHLY | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||