Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03048 | Date 17/01/2019 |
| Token No | SM/19-20/16489 10/01/2020 | Serial | 014 Last Visit: 18/01/2020 |
| Patient Name | Mrs. SHANTI SUDHA CHANDA | Contact No | 9681538237 |
| Address | 20 DR. G.C GOSWAMI STREET, SERAMPORE | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||