Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06839 | Date 11/11/2019 |
| Token No | SM/19-20/13057 11/11/2019 | Serial | 099 Last Visit: 16/06/2020 |
| Patient Name | Mrs. TAGARI PAL | Contact No | 8777056751 |
| Address | 8/A/1 CHATRA KUMAR PARA SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||