Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07919 | Date 24/03/2020 |
| Token No | SM/22-23/11885 21/04/2022 | Serial | 026 Last Visit: 22/06/2022 |
| Patient Name | Miss SHAMPA KUMARI SINGH | Contact No | 9831758618 |
| Address | 1 CHATRA MUSALMAN PARA CHATUGHANGE,SHEORAPHULI SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||