Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01526 | Date 05/10/2018 |
| Token No | SM/18-19/2768 11/10/2018 | Serial | 031 Last Visit: 11/10/2018 |
| Patient Name | Mrs. KANAN GANGULY | Contact No | 6291462599 |
| Address | 295 G T ROAD,CHATRA SHITALATALA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||