Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05464 | Date 18/06/2019 |
| Token No | SM/19-20/5246 25/06/2019 | Serial | 002 Last Visit: 15/10/2019 |
| Patient Name | Miss BRISTI MUKHERJEE | Contact No | 26527262 |
| Address | 104 AP GHOSH ROAD , CHATRA SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||