Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04349 | Date 23/03/2019 |
| Token No | SM/18-19/11057 23/03/2019 | Serial | 061 Last Visit: 23/03/2019 |
| Patient Name | Miss DEBAKI MUKHERJEE | Contact No | 8420319826 |
| Address | GOSAI PARA (NIKLESH BHAWAN) SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||