Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06922 | Date 19/11/2019 |
| Token No | SM/19-20/13586 19/11/2019 | Serial | 083 Last Visit: 19/11/2019 |
| Patient Name | Mrs. SARSWATI DEVI | Contact No | |
| Address | 22 CHATRA CHAKRABORTY LANE SERAMPORE | Age | 95 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||