Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06663 | Date 16/10/2019 |
| Token No | SM/19-20/11881 16/10/2019 | Serial | 099 Last Visit: 16/10/2019 |
| Patient Name | Miss SHUKLA MONDAL | Contact No | 9674497305 |
| Address | 29 DUTTA PARA LANE CHATRA SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||