Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06803 | Date 06/11/2019 |
| Token No | SM/19-20/13021 11/11/2019 | Serial | 063 Last Visit: 09/12/2019 |
| Patient Name | Mrs. SOBHA ADHIKARI | Contact No | 7044241217 |
| Address | 21 KUMIR JELA ROAD SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||