Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05307 | Date 31/05/2019 |
| Token No | SM/19-20/3769 31/05/2019 | Serial | 013 Last Visit: 31/05/2019 |
| Patient Name | Miss SONALI MAJUMDAR | Contact No | 9163842221 |
| Address | 2 RAJDHAR PUR | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||