Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04869 | Date 23/04/2019 |
| Token No | SM/19-20/2052 02/05/2019 | Serial | 023 Last Visit: 14/05/2019 |
| Patient Name | Mrs. SAOMA BANERJEE | Contact No | 9836572595 |
| Address | 19 A.P GHOSH ROAD SERAMPORE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 87 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||