Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05447 | Date 15/06/2019 |
| Token No | SM/19-20/7801 02/08/2019 | Serial | 033 Last Visit: 28/12/2019 |
| Patient Name | Mrs. SANDHA MONDAL | Contact No | 8910928678 |
| Address | 28A CHAKRABORTY LANE SERAMPORE | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||