Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06719 | Date 21/10/2019 |
| Token No | SM/19-20/12175 21/10/2019 | Serial | 072 Last Visit: 07/11/2019 |
| Patient Name | Mrs. PRIYANKA BERA | Contact No | 9330626356 |
| Address | 3 PARSI LANE SILBAGAN SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||