Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00528 | Date 17/08/2018 |
| Token No | SM/18-19/2053 25/09/2018 | Serial | 035 Last Visit: 12/07/2022 |
| Patient Name | Mrs. ANIMA MAITY | Contact No | 9874945349 |
| Address | 6/2 VIVEKANANDA LANE SERAMPORE | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||