Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04155 | Date 11/03/2019 |
| Token No | SM/18-19/10349 11/03/2019 | Serial | 058 Last Visit: 11/03/2019 |
| Patient Name | Mrs. RAMA MITRA | Contact No | |
| Address | 22 CHATRA BAJAR ROAD SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||