Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02213 | Date 29/11/2018 |
| Token No | SM/18-19/4383 29/11/2018 | Serial | 044 Last Visit: 30/11/2018 |
| Patient Name | Mrs. SHYAMALI GHOSH | Contact No | 8981550126 |
| Address | 48/B MUKHERJEE PARA LANE SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||