Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05403 | Date 12/06/2019 |
| Token No | SM/19-20/24776 06/08/2020 | Serial | 051 Last Visit: 26/08/2020 |
| Patient Name | Miss DEBJANI DHARA | Contact No | 8648880677 |
| Address | 132 N.S AVENUE SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||