Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07086 | Date 06/12/2019 |
| Token No | SM/19-20/14744 06/12/2019 | Serial | 001 Last Visit: 06/12/2019 |
| Patient Name | Mrs. MITHU GUPTA | Contact No | 7998384277 |
| Address | 36B MIYAJAN DARJI LANE SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||