Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04166 | Date 11/03/2019 |
| Token No | SM/18-19/10373 11/03/2019 | Serial | 082 Last Visit: 11/03/2019 |
| Patient Name | Mrs. PARAMITA LAHIRI | Contact No | 9830659751 |
| Address | 39D BENIYA PARA LANE SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||