Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04750 | Date 17/04/2019 |
| Token No | SM/19-20/1078 17/04/2019 | Serial | 085 Last Visit: 17/04/2019 |
| Patient Name | Mrs. CHAITALI KUNDU DAS | Contact No | 9883531363 |
| Address | 16 PN CHAKRABORTY LANE CHATRA SERAMPORE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||