Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02358 | Date 05/12/2018 |
| Token No | SM/18-19/6868 16/01/2019 | Serial | 014 Last Visit: 24/05/2019 |
| Patient Name | Mrs. NAMITARANI MONDAL | Contact No | 9903314006 |
| Address | 61A THAKUR DAS BABU LANE, SERAMPORE | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||