Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07142 | Date 13/12/2019 |
| Token No | SM/19-20/15222 13/12/2019 | Serial | 058 Last Visit: 13/12/2019 |
| Patient Name | Mrs. KAJAL SIMLAI | Contact No | 6290651790 |
| Address | 35/A SASHIBHUSAN GHOSH LANE SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||