Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01573 | Date 09/10/2018 |
| Token No | SM/18-19/8915 18/02/2019 | Serial | 088 Last Visit: 18/02/2019 |
| Patient Name | Mrs. SARBANI BHATTCHARYA | Contact No | 9239263839 |
| Address | 69A/1 BARO BAGAN SERAMPORE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||