Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03520 | Date 12/02/2019 |
| Token No | SM/18-19/8503 12/02/2019 | Serial | 107 Last Visit: 12/02/2019 |
| Patient Name | Mrs. MOUMITA DAS | Contact No | 8017275585 |
| Address | 47A MUKHERJEE PARA LANE SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||