Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04344 | Date 23/03/2019 |
| Token No | SM/18-19/11035 23/03/2019 | Serial | 039 Last Visit: 23/03/2019 |
| Patient Name | Mrs. PADHMA MUKHERKEE | Contact No | 9231696924 |
| Address | 10A VIVEKANAND LANE SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||