Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04238 | Date 15/03/2019 |
| Token No | SM/18-19/10600 15/03/2019 | Serial | 093 Last Visit: 15/03/2019 |
| Patient Name | Mrs. SAUMITA MUKHERJEE | Contact No | 7449412661 |
| Address | CHATRA KUMAR PARA SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||