Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06011 | Date 30/07/2019 |
| Token No | SM/19-20/7617 30/07/2019 | Serial | 066 Last Visit: 31/07/2019 |
| Patient Name | Mrs. MOUSUMI MALIK | Contact No | 6289769071 |
| Address | 27 BYE BARO BAGAN SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||