Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11127 | Date 14/06/2022 |
| Token No | SM/22-23/13550 14/06/2022 | Serial | 030 Last Visit: 14/06/2022 |
| Patient Name | Miss SITAL KUMARI JAISWARA | Contact No | |
| Address | 11, RABINDRA BHABAN ROAD SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||