Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06645 | Date 15/10/2019 |
| Token No | SM/19-20/11774 15/10/2019 | Serial | 052 Last Visit: 10/09/2020 |
| Patient Name | Mrs. DIPTI PAL | Contact No | 9874719824 |
| Address | 13/A KUMAR PARA CHATRA , SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||