Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04113 | Date 09/03/2019 |
| Token No | SM/18-19/10232 09/03/2019 | Serial | 023 Last Visit: 09/03/2019 |
| Patient Name | Mrs. TRIPTI DAS | Contact No | 9038209408 |
| Address | 10A BARO BAGAN LANE SERAMPORE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||