Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04719 | Date 16/04/2019 |
| Token No | SM/19-20/974 16/04/2019 | Serial | 090 Last Visit: 16/04/2019 |
| Patient Name | Miss SADIA KHATUN | Contact No | 9331935987 |
| Address | 48 N.N RAY STREET SERAMPORE | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||