Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06185 | Date 21/08/2019 |
| Token No | SM/19-20/8857 21/08/2019 | Serial | 019 Last Visit: 21/08/2019 |
| Patient Name | Mrs. MOUMITA BASAK | Contact No | 7044171517 |
| Address | SERAMPORE COLLNEY MALLICK PARA , SERAMPORE | Age | 32 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||