Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04067 | Date 07/03/2019 |
| Token No | SM/18-19/10084 07/03/2019 | Serial | 087 Last Visit: 30/04/2019 |
| Patient Name | Mrs. BHARATI RUI DAS | Contact No | 6290315698 |
| Address | 6 DR BR AMBEDKAR LANE, SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||