Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04723 | Date 16/04/2019 |
| Token No | SM/19-20/982 16/04/2019 | Serial | 098 Last Visit: 16/04/2019 |
| Patient Name | Mrs. NOMITA SEN | Contact No | 9830736781 |
| Address | 13 N.N RAY STREET SERAMPORE | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||