Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06820 | Date 07/11/2019 |
| Token No | SM/19-20/12901 07/11/2019 | Serial | 072 Last Visit: 07/11/2019 |
| Patient Name | Mrs. SAGARIKA DUTTA | Contact No | 9836110778 |
| Address | 53A MALLICKPARA SERAMPORE(M) | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||