Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11076 | Date 30/05/2022 |
| Token No | SM/22-23/13055 30/05/2022 | Serial | 046 Last Visit: 30/05/2022 |
| Patient Name | Miss MADHURIMA KUNDU | Contact No | 7059584284 |
| Address | 11/A MUSALMAN PARA ROAD SERAMPORE | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||