Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04331 | Date 20/03/2019 |
| Token No | SM/18-19/10982 20/03/2019 | Serial | 087 Last Visit: 24/01/2020 |
| Patient Name | Miss SUCHETA BANERJEE | Contact No | 8240099519 |
| Address | 1/1 PN CHAKRABORTY LANE CHATRA SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||