Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09681 | Date 07/06/2021 |
| Token No | SM/21-22/1963 07/06/2021 | Serial | 002 Last Visit: 07/06/2021 |
| Patient Name | Miss KAUSHALI BENERJEE | Contact No | 8478964764 |
| Address | 75/50 NABIN CHAQNDRA CHAKRABORTY LANE,BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||