Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03491 | Date 12/02/2019 |
| Token No | SM/19-20/8165 08/08/2019 | Serial | 030 Last Visit: 16/08/2019 |
| Patient Name | Mrs. SARBANI RAY CHOWDHURY | Contact No | 9330629590 |
| Address | 8B/1 M.C LAHIRI STREET SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||