Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00404 | Date 13/08/2018 |
| Token No | SM/21-22/1824 01/06/2021 | Serial | 001 Last Visit: 27/07/2021 |
| Patient Name | Baby SONAMONI HAZRA | Contact No | 9883845385 |
| Address | 32, PANCHU BABU BAZAR, SERAMPORE | Age | 3.3 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||