Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01819 | Date 01/11/2018 |
| Token No | SM/18-19/3267 01/11/2018 | Serial | 016 Last Visit: 20/07/2019 |
| Patient Name | Miss MITUL SARKAR | Contact No | 7278843809 |
| Address | 37/F CHATRA DHARMOTALA SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||