Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04874 | Date 23/04/2019 |
| Token No | SM/19-20/1518 23/04/2019 | Serial | 099 Last Visit: 23/04/2019 |
| Patient Name | Mrs. KALPANA JASH | Contact No | 9088055787 |
| Address | 16 K.M SAHA STREET , SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||