Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04514 | Date 02/04/2019 |
| Token No | SM/19-20/105 02/04/2019 | Serial | 043 Last Visit: 02/04/2019 |
| Patient Name | Mrs. LINA CHAKRABORTY | Contact No | 8017626792 |
| Address | 8B DR, G.C GOSWAMI STREET SERAMPORE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||