Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02929 | Date 09/01/2019 |
| Token No | SM/18-19/8272 07/02/2019 | Serial | 099 Last Visit: 07/02/2019 |
| Patient Name | Mrs. UMA CHAKRABORTY | Contact No | 8420171074 |
| Address | RAJA K L GOSWAMI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||