Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04544 | Date 04/04/2019 |
| Token No | SM/19-20/236 04/04/2019 | Serial | 025 Last Visit: 17/04/2019 |
| Patient Name | Mrs. MONIKA DUTTA | Contact No | 9748032965 |
| Address | CHATRA BAGAR BAGAN SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||