Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05599 | Date 27/06/2019 |
| Token No | SM/19-20/5471 27/06/2019 | Serial | 054 Last Visit: 05/12/2019 |
| Patient Name | Miss SUMITA BARMAN | Contact No | 9331721026 |
| Address | 18/E CHATRA CHOWDHURY PARA BYE LANE SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||