Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01180 | Date 18/09/2018 |
| Token No | SM/18-19/1738 18/09/2018 | Serial | 004 Last Visit: 18/09/2018 |
| Patient Name | Mrs. JAYA PAL | Contact No | 7003401065 |
| Address | 21 G , ROY M.C LAHIRI BAHADUR STREET SERAMPORE | Age | 38 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||