Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04739 | Date 17/04/2019 |
| Token No | SM/19-20/1046 17/04/2019 | Serial | 053 Last Visit: 17/04/2019 |
| Patient Name | Mrs. SARMILA SEAL | Contact No | 9903860938 |
| Address | 54 CHAKRABORTY LANE CHATRA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||