Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03804 | Date 22/02/2019 |
| Token No | SM/19-20/8185 08/08/2019 | Serial | 050 Last Visit: 08/08/2019 |
| Patient Name | Miss KOMAL SHAW | Contact No | 7890225796 |
| Address | 10/K CHATRA ROY M.C. LAHIRI STREET | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||