Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04280 | Date 18/03/2019 |
| Token No | SM/18-19/10758 18/03/2019 | Serial | 057 Last Visit: 18/03/2019 |
| Patient Name | Miss RUPSA KHATUN | Contact No | 9748638199 |
| Address | 1 DR, CHATERJEE BYE LANE TIKIYAPARA SERAMPORE(M) | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||