Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04705 | Date 16/04/2019 |
| Token No | SM/19-20/914 16/04/2019 | Serial | 030 Last Visit: 16/04/2019 |
| Patient Name | Miss MISTI MONDAL | Contact No | 8017854602 |
| Address | CHATRA MANA PARA SERAMPORE | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||