Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03231 | Date 30/01/2019 |
| Token No | SM/21-22/6074 22/10/2021 | Serial | 005 Last Visit: 22/10/2021 |
| Patient Name | Miss SOUMILY SEAL | Contact No | 9830570138 |
| Address | 26 BHADURI LANE SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||