Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01808 | Date 31/10/2018 |
| Token No | SM/18-19/3245 31/10/2018 | Serial | 049 Last Visit: 19/08/2019 |
| Patient Name | Miss SHIYA ADHIKARY | Contact No | 9432087225 |
| Address | 79K N.N. RAY STREET SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||