Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05463 | Date 17/06/2019 |
| Token No | SM/19-20/4742 17/06/2019 | Serial | 059 Last Visit: 17/06/2019 |
| Patient Name | Miss SANIA KHATOON | Contact No | 9674808170 |
| Address | 12 MUSALMAN PRA BYE LANE CHATRA SERAMPORE | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||