Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05370 | Date 10/06/2019 |
| Token No | SM/19-20/4275 10/06/2019 | Serial | 057 Last Visit: 24/02/2020 |
| Patient Name | Mrs. ISHIKA BANERJEE | Contact No | 9051189326 |
| Address | 119 CHATRA MUKHERJEE PARA CHATRA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||