Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03722 | Date 20/02/2019 |
| Token No | SM/18-19/9089 20/02/2019 | Serial | 027 Last Visit: 20/02/2019 |
| Patient Name | Mrs. SHAMA PRAVEEN | Contact No | 8100051436 |
| Address | 60/A N.N ROY STREET SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||