Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01769 | Date 30/10/2018 |
| Token No | SM/18-19/3444 05/11/2018 | Serial | 004 Last Visit: 30/03/2020 |
| Patient Name | Mrs. SHIBANI NAG | Contact No | 9088430965 |
| Address | 23, RAY GHAT LANE SERAMPORE | Age | 76 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||