Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04744 | Date 17/04/2019 |
| Token No | SM/19-20/1059 17/04/2019 | Serial | 066 Last Visit: 17/04/2019 |
| Patient Name | Miss PRIYA PYNE | Contact No | 8013355731 |
| Address | 55 CHATRA BARUI PARA LANE SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||