Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04764 | Date 18/04/2019 |
| Token No | SM/19-20/1168 18/04/2019 | Serial | 081 Last Visit: 26/04/2019 |
| Patient Name | Mrs. NUPUR DUTTA | Contact No | 9836515118 |
| Address | 18 RAJA K.L GOSWAMI STREET SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||