Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05456 | Date 17/06/2019 |
| Token No | SM/19-20/4701 17/06/2019 | Serial | 018 Last Visit: 17/06/2019 |
| Patient Name | Miss NASHREE | Contact No | 8478988101 |
| Address | 89C MALLIK PARA SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||