Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05337 | Date 06/06/2019 |
| Token No | SM/19-20/4363 11/06/2019 | Serial | 039 Last Visit: 18/06/2019 |
| Patient Name | Mrs. ANNAPURNA GANGULY | Contact No | |
| Address | 108 RAJDHARPUR GOVT COLONY SERAMPORE | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||