Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 07440 | Date 28/01/2020 |
| Token No | SM/19-20/17363 28/01/2020 | Serial | 056 Last Visit: 28/01/2020 |
| Patient Name | Miss DOTI GHOSH | Contact No | 9038618747 |
| Address | 85/D KHATIR BAZAR LANE SERAMPORE MAHESH | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||