Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 04773 | Date 20/04/2019 |
| Token No | SM/19-20/13349 16/11/2019 | Serial | 009 Last Visit: 26/11/2019 |
| Patient Name | Mrs. MOUMITA BISWAS | Contact No | 7890991151 |
| Address | 16, K.M SAHA STREET SERAMPORE (M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||