Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04941 | Date 27/04/2019 |
| Token No | SM/19-20/1807 27/04/2019 | Serial | 056 Last Visit: 27/04/2019 |
| Patient Name | Miss RITWIKA MALLICK | Contact No | 9748725998 |
| Address | 17,DR P.N. MUKHERJEE STREET | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||