Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01092 | Date 13/09/2018 |
| Token No | SM/18-19/1927 22/09/2018 | Serial | 040 Last Visit: 24/05/2021 |
| Patient Name | Mrs. SABITA MONDAL | Contact No | 8583907269 |
| Address | 32 CHAKRABORTY LANE SERAMPORE | Age | 58.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||