Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01323 | Date 25/09/2018 |
| Token No | SM/18-19/6813 15/01/2019 | Serial | 006 Last Visit: 04/04/2020 |
| Patient Name | Mrs. SARNALI MANNA | Contact No | 7890749613 |
| Address | 16, CHAKRABORTY LANE SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||