Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04249 | Date 16/03/2019 |
| Token No | SM/18-19/10640 16/03/2019 | Serial | 022 Last Visit: 16/03/2019 |
| Patient Name | Mrs. SOMA PRAMANIK | Contact No | 9748226706 |
| Address | BAKULIA, BALAGAR HOOGHLY | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||