Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07260 | Date 31/12/2019 |
| Token No | SM/19-20/16068 31/12/2019 | Serial | 010 Last Visit: 11/01/2020 |
| Patient Name | Miss NABAMITA MUKHERJEE | Contact No | 7439079044 |
| Address | 104 A.P GHOSH ROAD SERAMPORE CHATRA | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||