Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04168 | Date 11/03/2019 |
| Token No | SM/19-20/19162 05/03/2020 | Serial | 043 Last Visit: 05/11/2020 |
| Patient Name | Miss LAKSHMI SAHA | Contact No | 9874178224 |
| Address | 55 BARO BAGAN LANE, MALLICKPARA ,SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||