Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06289 | Date 31/08/2019 |
| Token No | SM/19-20/9522 31/08/2019 | Serial | 003 Last Visit: 31/08/2019 |
| Patient Name | Mrs. MUKTI DAS | Contact No | 7044395458 |
| Address | 37 DR. GC GOSWAMI STREET SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||