Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05231 | Date 25/05/2019 |
| Token No | SM/19-20/7225 24/07/2019 | Serial | 067 Last Visit: 24/07/2019 |
| Patient Name | Miss CHANDRIMA CHAKRABORTY | Contact No | 8697162161 |
| Address | 41 A.P GHOSH ROAD SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||