Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06933 | Date 20/11/2019 |
| Token No | SM/19-20/13653 20/11/2019 | Serial | 062 Last Visit: 20/11/2019 |
| Patient Name | Miss SAIKA KHATUN | Contact No | 7890566765 |
| Address | 16B RABINDRA BHAWAN ROAD , SERAMPORE | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||