Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02707 | Date 27/12/2018 |
| Token No | SM/19-20/3328 24/05/2019 | Serial | 013 Last Visit: 27/07/2020 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9932173738 |
| Address | 7, DR. BAGAN LANE SERAMPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||