Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05218 | Date 24/05/2019 |
| Token No | SM/19-20/3341 24/05/2019 | Serial | 026 Last Visit: 24/05/2019 |
| Patient Name | Mrs. SIMA DAS | Contact No | 8961304879 |
| Address | DR CHATERJEE LANE NEAR JOT NURSHING HOME SERAMPORE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||