Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06968 | Date 23/11/2019 |
| Token No | SM/19-20/13850 23/11/2019 | Serial | 045 Last Visit: 23/11/2019 |
| Patient Name | Mrs. SHYAMALI DAS | Contact No | 9007971018 |
| Address | 22 PANDIT NANDA KUMAR BANERJEE LANE SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||