Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01364 | Date 26/09/2018 |
| Token No | SM/20-21/26322 05/10/2020 | Serial | 058 Last Visit: 05/10/2020 |
| Patient Name | Mrs. JHUMA DAS | Contact No | 9088518614 |
| Address | 3 A VIVEKANAND LANE, SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||