Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04427 | Date 27/03/2019 |
| Token No | SM/18-19/11375 27/03/2019 | Serial | 079 Last Visit: 16/04/2019 |
| Patient Name | Mrs. LAKSHMI DUTTA | Contact No | 7044976062 |
| Address | 18 CHATRA JAGO MAHAN LAHIRI LANE ,SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||