Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03587 | Date 14/02/2019 |
| Token No | SM/18-19/10194 08/03/2019 | Serial | 085 Last Visit: 08/03/2019 |
| Patient Name | Mrs. PIU GHOSH | Contact No | 9674178951 |
| Address | 10/C CHATRA CHAPA TALA LANE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||