Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06152 | Date 19/08/2019 |
| Token No | SM/19-20/9994 07/09/2019 | Serial | 063 Last Visit: 14/02/2020 |
| Patient Name | Miss SARINA KHATUN | Contact No | 9163515207 |
| Address | 7 ARBINDA SARANI CHATRA SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||