Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04551 | Date 04/04/2019 |
| Token No | SM/19-20/9253 27/08/2019 | Serial | 061 Last Visit: 14/09/2019 |
| Patient Name | Miss DIMPAL JAISWARA | Contact No | 8697302661 |
| Address | 11 RABINDRA BHABAN, SERAMPORE | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||