Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04237 | Date 15/03/2019 |
| Token No | SM/18-19/10599 15/03/2019 | Serial | 092 Last Visit: 30/03/2019 |
| Patient Name | Mrs. LAKHI NATH | Contact No | 9875691856 |
| Address | CHATRA KUMAR PARA SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||