Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06347 | Date 06/09/2019 |
| Token No | SM/19-20/9888 06/09/2019 | Serial | 053 Last Visit: 06/09/2019 |
| Patient Name | Miss PIASHA BAG | Contact No | |
| Address | 12/A/1/A LAHIRI PARA LANE CHATRA SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||