Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02369 | Date 06/12/2018 |
| Token No | SM/18-19/4757 06/12/2018 | Serial | 012 Last Visit: 06/12/2018 |
| Patient Name | Mrs. PRITI GUIN | Contact No | 9007170839 |
| Address | 31 THAKUR DAS BABU LANE SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||