Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07132 | Date 12/12/2019 |
| Token No | SM/19-20/15123 12/12/2019 | Serial | 043 Last Visit: 13/12/2019 |
| Patient Name | Mrs. PAMPA RAY | Contact No | 9874270636 |
| Address | 16 RAJA K.L GOSWAMI STREET SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||