Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06288 | Date 31/08/2019 |
| Token No | SM/19-20/9521 31/08/2019 | Serial | 002 Last Visit: 16/09/2019 |
| Patient Name | Mrs. SHIKHA DAS | Contact No | 9007014002 |
| Address | 31/A DR. G.C GOSWAMI STREET SERAMPORE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||