Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09473 | Date 17/04/2021 |
| Token No | SM/21-22/511 17/04/2021 | Serial | 004 Last Visit: 17/04/2021 |
| Patient Name | Miss AVISHA BERA | Contact No | 6290768678 |
| Address | 12 JAGA MOHAN LAHIRI LANE CHATRA SERAMPORE | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||