Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03166 | Date 24/01/2019 |
| Token No | SM/18-19/7394 24/01/2019 | Serial | 081 Last Visit: 24/01/2019 |
| Patient Name | Mrs. KRISHNA KARMOKAR | Contact No | 8013700472 |
| Address | 25 CHAKRABORTY LANE SERAMPORE | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||