Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04195 | Date 13/03/2019 |
| Token No | SM/18-19/10553 15/03/2019 | Serial | 046 Last Visit: 15/03/2019 |
| Patient Name | Mrs. DOLLY MONDAL | Contact No | 7003567240 |
| Address | N.N RAY STREET SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||