Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01809 | Date 31/10/2018 |
| Token No | SM/19-20/19067 04/03/2020 | Serial | 041 Last Visit: 13/07/2020 |
| Patient Name | Mrs. SHAMPA ADHIKARY | Contact No | 9432087225 |
| Address | 79K N.N. RAY STREET SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||