Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06764 | Date 31/10/2019 |
| Token No | SM/19-20/12836 07/11/2019 | Serial | 007 Last Visit: 07/11/2019 |
| Patient Name | Mrs. MANUSHREE MONDAL | Contact No | 9804765711 |
| Address | 12/C BYE SERAMPORE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||