Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07533 | Date 13/02/2020 |
| Token No | SM/19-20/18035 13/02/2020 | Serial | 054 Last Visit: 13/02/2020 |
| Patient Name | Mrs. BANI KARMAKAR SEN | Contact No | 9432836970 |
| Address | 59/L KUMIR JALA ROAD SERAMPORE MALLICK PARA | Age | 28 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||