Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04875 | Date 23/04/2019 |
| Token No | SM/19-20/1525 23/04/2019 | Serial | 106 Last Visit: 23/04/2019 |
| Patient Name | Mrs. GITA DUTTA | Contact No | 7596940550 |
| Address | 195 RAJDHARPUR GOVT. COLLNEY SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||