Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02111 | Date 24/11/2018 |
| Token No | SM/19-20/1424 23/04/2019 | Serial | 005 Last Visit: 12/06/2020 |
| Patient Name | Miss SANCHITA LAHA | Contact No | 9831878648 |
| Address | 101/B CHATRA BARUI PARA, SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||