Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02184 | Date 28/11/2018 |
| Token No | SM/18-19/4312 28/11/2018 | Serial | 044 Last Visit: 28/11/2018 |
| Patient Name | Mrs. MAYA LAHIRI | Contact No | 26522326 |
| Address | 39/C BANIYA PARA LANE SERAMPORE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||