Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07379 | Date 20/01/2020 |
| Token No | SM/19-20/16954 20/01/2020 | Serial | 067 Last Visit: 20/01/2020 |
| Patient Name | Mrs. LAKSHMI BARIK | Contact No | 9073829687 |
| Address | CHOTO BELUR CHECK POST SARDAR PARA , SERAMPORE | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||