Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00030 | Date 01/08/2018 |
| Token No | SM/19-20/11547 10/10/2019 | Serial | 015 Last Visit: 10/10/2019 |
| Patient Name | Mrs. REKHA KARMAKAR | Contact No | 9051612169 |
| Address | 57T G.T ROAD MANNA PARA,CHATRA SERAMPORE | Age | 45.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||