Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03623 | Date 16/02/2019 |
| Token No | SM/19-20/12801 06/11/2019 | Serial | 054 Last Visit: 13/03/2020 |
| Patient Name | Miss TITLE LAHA | Contact No | 7439187122 |
| Address | 13/A CHATRA DUTTA PARA, SERAMPORE | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||