Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04982 | Date 30/04/2019 |
| Token No | SM/19-20/13574 19/11/2019 | Serial | 071 Last Visit: 19/11/2019 |
| Patient Name | Mrs. ARCHANA GHOSH | Contact No | 9062909518 |
| Address | 21 CHAKRABORTY LANE SERAMPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||