Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03974 | Date 02/03/2019 |
| Token No | SM/18-19/9769 02/03/2019 | Serial | 088 Last Visit: 02/03/2019 |
| Patient Name | Miss PHALGUNI CHAKRABORTY | Contact No | 8697421914 |
| Address | BARO BAGAN,SERAMPORE, | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||