Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07811 | Date 16/03/2020 |
| Token No | SM/19-20/19725 16/03/2020 | Serial | 049 Last Visit: 04/06/2020 |
| Patient Name | Mrs. SUSUM CHANDRA | Contact No | 8017641028 |
| Address | 32/U DOCTOR BAGAN LANE SERAMPORE MALLICKPARA | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||