Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03567 | Date 13/02/2019 |
| Token No | SM/18-19/8625 13/02/2019 | Serial | 092 Last Visit: 22/08/2019 |
| Patient Name | Mrs. PURNIMA BHATTACHARJEE | Contact No | 9088844278 |
| Address | 29 GT ROAD SERAMPORE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||