Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04642 | Date 09/04/2019 |
| Token No | SM/19-20/579 09/04/2019 | Serial | 033 Last Visit: 09/04/2019 |
| Patient Name | Miss SENORITA SHOW | Contact No | 8478878035 |
| Address | 107 RAM KRISHNA ROAD,BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||