Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05138 | Date 16/05/2019 |
| Token No | SM/19-20/2867 16/05/2019 | Serial | 029 Last Visit: 16/05/2019 |
| Patient Name | Mrs. MUNMUN SK | Contact No | 8420934586 |
| Address | CHATRA GODAR BAGAN SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||