Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05156 | Date 20/05/2019 |
| Token No | SM/19-20/3213 22/05/2019 | Serial | 054 Last Visit: 22/05/2019 |
| Patient Name | Mrs. MAMTA SONI | Contact No | 8481050468 |
| Address | 27A TINBAJAR BYE LANE SERAMPORE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||