Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04145 | Date 11/03/2019 |
| Token No | SM/18-19/10320 11/03/2019 | Serial | 029 Last Visit: 11/03/2019 |
| Patient Name | Mrs. SUSHMA SANTRA | Contact No | 9874381059 |
| Address | 34 BHADURI PARA CHATRA SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||