Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07019 | Date 29/11/2019 |
| Token No | SM/19-20/14325 29/11/2019 | Serial | 094 Last Visit: 29/11/2019 |
| Patient Name | Mrs. GITA DEBNATH | Contact No | 9830701781 |
| Address | 55 GT ROAD (WEST) SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||