Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07012 | Date 29/11/2019 |
| Token No | SM/19-20/15892 26/12/2019 | Serial | 023 Last Visit: 08/06/2021 |
| Patient Name | Mrs. SIMA DOLUI | Contact No | 7890676273 |
| Address | DAKSHIN RAJDHAR PUR PASCHIM PARA SERAMPORE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||