Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04893 | Date 24/04/2019 |
| Token No | SM/19-20/1577 24/04/2019 | Serial | 047 Last Visit: 24/04/2019 |
| Patient Name | Mrs. SONA RAJAK | Contact No | |
| Address | 17 MC ROY BAHADUR STREET , SERAMPORE | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||