Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03519 | Date 12/02/2019 |
| Token No | SM/18-19/8501 12/02/2019 | Serial | 105 Last Visit: 18/03/2021 |
| Patient Name | Miss RUKSA KHATUN | Contact No | 7003407003 |
| Address | 16/B GOPINATH SAHA STREET, SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||