Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04230 | Date 15/03/2019 |
| Token No | SM/18-19/10980 20/03/2019 | Serial | 085 Last Visit: 20/03/2019 |
| Patient Name | Mrs. INDRANI LAHIRI | Contact No | 6289139746 |
| Address | 39/B BANIYA PARA LANE SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||