Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01615 | Date 11/10/2018 |
| Token No | SM/19-20/3250 22/05/2019 | Serial | 091 Last Visit: 05/10/2019 |
| Patient Name | Mrs. ILIKA PAL | Contact No | 9732338031 |
| Address | 24 A.K DUTTA SARANI USANGAR APARTMENT | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||