Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03506 | Date 12/02/2019 |
| Token No | SM/18-19/8450 12/02/2019 | Serial | 054 Last Visit: 12/02/2019 |
| Patient Name | Miss SOHINI GHOSH | Contact No | 8013791415 |
| Address | CHAMPA TALA LANE SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||