Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03931 | Date 01/03/2019 |
| Token No | SM/19-20/4983 21/06/2019 | Serial | 009 Last Visit: 23/07/2019 |
| Patient Name | Miss KRITTIKA PAL | Contact No | 9831575378 |
| Address | 13B/1CHATRA KUMARPARA/LANE SERAMPORE HOOGHLY | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||