Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07075 | Date 05/12/2019 |
| Token No | SM/19-20/14695 05/12/2019 | Serial | 023 Last Visit: 05/12/2019 |
| Patient Name | Miss SOUMI MUKHERJEE | Contact No | 6289869004 |
| Address | 142 RAMKRISHNA ROAD , BAIDYABATI(M) | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||