Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04203 | Date 15/03/2019 |
| Token No | SM/18-19/10729 18/03/2019 | Serial | 028 Last Visit: 18/03/2019 |
| Patient Name | Mrs. SARATI BISWAS | Contact No | |
| Address | 16 RAJA K.L GOSWAMI STREET SEARMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||