Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02343 | Date 05/12/2018 |
| Token No | SM/18-19/4679 05/12/2018 | Serial | 003 Last Visit: 05/12/2018 |
| Patient Name | Miss SUMANA MUKHERJEE | Contact No | |
| Address | 76 N N ROY STREET, | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||