Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04585 | Date 06/04/2019 |
| Token No | SM/19-20/380 06/04/2019 | Serial | 008 Last Visit: 16/04/2019 |
| Patient Name | Miss DEBOSMITA DAS | Contact No | 8420676675 |
| Address | 3/C GHOSH PARA 1ST LANE CHATRA , SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||