Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04988 | Date 30/04/2019 |
| Token No | SM/19-20/1994 30/04/2019 | Serial | 062 Last Visit: 30/04/2019 |
| Patient Name | Miss NILAM JAISWARA | Contact No | 6289512236 |
| Address | 11 RABINDRA BHABAN ROAD SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||