Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04821 | Date 22/04/2019 |
| Token No | SM/19-20/1382 22/04/2019 | Serial | 097 Last Visit: 22/04/2019 |
| Patient Name | Miss KAUSHALI BANERJEE | Contact No | 8478964764 |
| Address | 75/50 NABIN CHANDRA CHAKRABOTY LANE , BAIDYABATI(M) | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||