Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04126 | Date 09/03/2019 |
| Token No | SM/18-19/10267 09/03/2019 | Serial | 058 Last Visit: 15/03/2019 |
| Patient Name | Mrs. SHYAMASREE SINGH | Contact No | 9163520484 |
| Address | 51 MUKHERJEE PARA SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||