Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06084 | Date 07/08/2019 |
| Token No | SM/19-20/8126 07/08/2019 | Serial | 069 Last Visit: 07/08/2019 |
| Patient Name | Miss SUDIPA BOSE | Contact No | 8478843338 |
| Address | 7 DEY BAGAN LANE SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||