Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00317 | Date 10/08/2018 |
| Token No | SM/19-20/10690 19/09/2019 | Serial | 072 Last Visit: 23/07/2020 |
| Patient Name | Mrs. MADHUMITA HALDAR | Contact No | 8961162974 |
| Address | 133, BARUI PARA LANE , SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||