Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02738 | Date 29/12/2018 |
| Token No | SM/18-19/5983 29/12/2018 | Serial | 038 Last Visit: 29/12/2018 |
| Patient Name | Miss KANKANA CHAKRABORTY | Contact No | 8013122124 |
| Address | 2/A LAHIRA PARA LANE CHATRA SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||