Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 05480 | Date 18/06/2019 |
| Token No | SM/19-20/4830 18/06/2019 | Serial | 088 Last Visit: 18/06/2019 |
| Patient Name | Miss BHAWNA PASI | Contact No | 9433196115 |
| Address | 50 GANGULY BAGAN LANE MAHESH SERAMPORE | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||