Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05061 | Date 10/05/2019 |
| Token No | SM/19-20/2449 10/05/2019 | Serial | 046 Last Visit: 10/05/2019 |
| Patient Name | Mrs. BARNASHREE GHOSH | Contact No | 9831742951 |
| Address | 50/B RAMKRISHNA ROAD CHATRA SERAMPORE , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||