Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05514 | Date 21/06/2019 |
| Token No | SM/19-20/5033 21/06/2019 | Serial | 059 Last Visit: 21/06/2019 |
| Patient Name | Mrs. SANDHYA RANI RAY | Contact No | 9830429325 |
| Address | 5 PANDIT KALI NATH BHATTCHARJEE LANE SERAMPORE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||