Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04216 | Date 15/03/2019 |
| Token No | SM/18-19/10554 15/03/2019 | Serial | 047 Last Visit: 15/03/2019 |
| Patient Name | Mrs. MOUSUMI MONDAL | Contact No | 9836233241 |
| Address | N.N RAY STREET SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||