Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05458 | Date 17/06/2019 |
| Token No | SM/19-20/4716 17/06/2019 | Serial | 033 Last Visit: 17/06/2019 |
| Patient Name | Miss PUTUL DAS | Contact No | 7449881678 |
| Address | 8 KANHAI DEWAN TALA BYE LANE, SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||