Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06385 | Date 12/09/2019 |
| Token No | SM/19-20/10652 19/09/2019 | Serial | 034 Last Visit: 19/09/2019 |
| Patient Name | Mrs. SUSMITA SARKAR | Contact No | 9681456590 |
| Address | PROMOD PALLY SERAMPORE DAKSHIN RAJYADHARPUR MALLICKPARA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||