Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05134 | Date 16/05/2019 |
| Token No | SM/19-20/2851 16/05/2019 | Serial | 013 Last Visit: 17/05/2019 |
| Patient Name | Mrs. JHUMPA ROY | Contact No | 8336828452 |
| Address | 50 N.N RAY STREET SERAMPORE | Age | 31 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||