Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07875 | Date 21/03/2020 |
| Token No | SM/19-20/20050 21/03/2020 | Serial | 006 Last Visit: 21/03/2020 |
| Patient Name | Miss ANESWA CHAKRABORTY | Contact No | 9123996482 |
| Address | 11/D DR. P.N MUKHERJEE STREET CHATRA SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||