Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05139 | Date 16/05/2019 |
| Token No | SM/19-20/8352 10/08/2019 | Serial | 073 Last Visit: 10/08/2019 |
| Patient Name | Miss SUROBHI KOLAY | Contact No | 7044681038 |
| Address | 15 RAY GHAT LANE SERAMPORE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||