Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07213 | Date 21/12/2019 |
| Token No | SM/19-20/15746 21/12/2019 | Serial | 054 Last Visit: 21/12/2019 |
| Patient Name | Mrs. SAMAN | Contact No | 9816058773 |
| Address | 6 G.C GOSWAMI STREET SERAMPORE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||