Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04688 | Date 12/04/2019 |
| Token No | SM/19-20/812 12/04/2019 | Serial | 049 Last Visit: 12/04/2019 |
| Patient Name | Miss PIYA SARKAR | Contact No | 8013175966 |
| Address | 32, BARAL BAGAN LANE SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||