Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04708 | Date 16/04/2019 |
| Token No | SM/19-20/997 17/04/2019 | Serial | 004 Last Visit: 05/11/2019 |
| Patient Name | Mrs. MANIKA GHOSH | Contact No | 9874635582 |
| Address | 34/A ROY MC LAHIRI STREET SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||