Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05677 | Date 05/07/2019 |
| Token No | SM/19-20/5933 05/07/2019 | Serial | 096 Last Visit: 05/07/2019 |
| Patient Name | Miss ROJINA NEGAR | Contact No | 7890600731 |
| Address | TIN BAZAR PANCHU GOPAL BAHDURI SARANI , SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||