Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05468 | Date 18/06/2019 |
| Token No | SM/19-20/4776 18/06/2019 | Serial | 034 Last Visit: 19/06/2019 |
| Patient Name | Mrs. RIYA BANGAL | Contact No | 9331681223 |
| Address | 11 DR BAGAN LANE SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||