Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06110 | Date 10/08/2019 |
| Token No | SM/19-20/8338 10/08/2019 | Serial | 059 Last Visit: 10/08/2019 |
| Patient Name | Miss SANCHITA BISWAS | Contact No | 8697483029 |
| Address | 90 N.S AVENUE SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||