Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02401 | Date 07/12/2018 |
| Token No | SM/18-19/6703 11/01/2019 | Serial | 060 Last Visit: 17/04/2019 |
| Patient Name | Mrs. SULATA MAL | Contact No | 9836909834 |
| Address | 77 A/1 MUKHERJEE PARA LANE SERAMPORE | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||