Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04270 | Date 18/03/2019 |
| Token No | SM/18-19/10722 18/03/2019 | Serial | 021 Last Visit: 18/03/2019 |
| Patient Name | Mrs. SEFALI ADHIKARY | Contact No | 6290284008 |
| Address | 14 CHATRA CHOWDHURY PARA LANE SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | 110/70 mmHg | Weight | 54.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||