Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01181 | Date 18/09/2018 |
| Token No | SM/18-19/1739 18/09/2018 | Serial | 005 Last Visit: 18/09/2018 |
| Patient Name | Mrs. PALLABI HAZRA | Contact No | 7003401065 |
| Address | 21 G , ROY M.C LAHIRI BAHADUR STREET SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||