Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05822 | Date 18/07/2019 |
| Token No | SM/19-20/6750 18/07/2019 | Serial | 025 Last Visit: 18/07/2019 |
| Patient Name | Miss SHIBANI CHOWRASIA | Contact No | 8777657269 |
| Address | GUMODANGA,MOLLABER.HOOGHLY | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||