Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09069 | Date 18/12/2020 |
| Token No | SM/20-21/28896 30/12/2020 | Serial | 001 Last Visit: 30/12/2020 |
| Patient Name | Baby TISHA MAHATO | Contact No | 9007555681 |
| Address | 55/1 SACHTASHI PARA, SERMPORE | Age | 10 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||