Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06165 | Date 20/08/2019 |
| Token No | SM/19-20/8777 20/08/2019 | Serial | 056 Last Visit: 16/11/2019 |
| Patient Name | Baby MADHUMITA DALUI | Contact No | 9007680589 |
| Address | 14 CHATRA SIDDESWARI TALA LANE , SERAMPORE | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||