Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06702 | Date 21/10/2019 |
| Token No | SM/19-20/12110 21/10/2019 | Serial | 007 Last Visit: 21/10/2019 |
| Patient Name | Mrs. SOMA DUTTA | Contact No | 9143453173 |
| Address | 30 RAJA K.L GOSWAMI STREET SERAMPORE | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||