Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05283 | Date 29/05/2019 |
| Token No | SM/19-20/3657 29/05/2019 | Serial | 024 Last Visit: 29/05/2019 |
| Patient Name | Miss PAYEL CHOWDHURY | Contact No | 7595883309 |
| Address | 32 SURESH CHANDRA GANGULY LANE SALKIA HAORA (M.CORP) | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||