Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05159 | Date 20/05/2019 |
| Token No | SM/19-20/10306 13/09/2019 | Serial | 036 Last Visit: 13/09/2019 |
| Patient Name | Miss SEJUTI BHATTCHARJEE | Contact No | 9123083454 |
| Address | 80/33 GURU DAS BHATTCHARJEE LANE , BAIDYABATI(M) | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||