Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05023 | Date 07/05/2019 |
| Token No | SM/19-20/3372 24/05/2019 | Serial | 057 Last Visit: 24/05/2019 |
| Patient Name | Miss SAHELI BANERJEE | Contact No | 9836572595 |
| Address | 19 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||