Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04271 | Date 18/03/2019 |
| Token No | SM/18-19/10724 18/03/2019 | Serial | 023 Last Visit: 01/04/2019 |
| Patient Name | Mrs. MALINA ADHIKARY | Contact No | 6291229117 |
| Address | 21 KUMIR JELA ROAD SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||