Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06019 | Date 31/07/2019 |
| Token No | SM/19-20/13365 16/11/2019 | Serial | 025 Last Visit: 22/02/2020 |
| Patient Name | Mrs. SUNITA RAJAK | Contact No | |
| Address | CHECK POST CHOTO BELUR, SERAMPORE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||