Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06929 | Date 20/11/2019 |
| Token No | SM/19-20/13622 20/11/2019 | Serial | 031 Last Visit: 20/11/2019 |
| Patient Name | Miss SANCHARI DAS | Contact No | 9830962910 |
| Address | BENIAPARA LANE, SERAMPORE | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||