Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00820 | Date 29/08/2018 |
| Token No | SM/18-19/1049 30/08/2018 | Serial | 003 Last Visit: 28/03/2019 |
| Patient Name | Mrs. GITA DAS | Contact No | 8777693276 |
| Address | 146/2 SERAMPORE MAHESH COLLNEY | Age | 46 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | 122/58 mmHg | Weight | 40.5 KG |
| Pulse Rate | 73 / min | Height | cm BMI: inf |
| Diagnosis | |||