Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 11138 | Date 16/06/2022 |
| Token No | SM/22-23/13918 23/06/2022 | Serial | 037 Last Visit: 26/04/2023 |
| Patient Name | Miss ISHA DOM | Contact No | 6290339198 |
| Address | 95, HOSPITAL ROAD DAIRY FORM BARRACKPORE CHATRA KALIBABU GHAT SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||