Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03096 | Date 19/01/2019 |
| Token No | SM/18-19/7114 19/01/2019 | Serial | 047 Last Visit: 19/01/2019 |
| Patient Name | Miss TIRTHA CHATERJEE | Contact No | 8444967593 |
| Address | 10/F ROY MC LAHIRI STREET | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||