Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05207 | Date 23/05/2019 |
| Token No | SM/19-20/3271 23/05/2019 | Serial | 019 Last Visit: 23/05/2019 |
| Patient Name | Mrs. KRISHANA KOIRI | Contact No | 6290162335 |
| Address | 50 MUKHERJEE PARA LANE SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||