Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04294 | Date 19/03/2019 |
| Token No | SM/18-19/10830 19/03/2019 | Serial | 023 Last Visit: 19/03/2019 |
| Patient Name | Mrs. KAMALIKA GHOSH | Contact No | 9836049676 |
| Address | MAHKORDAHO,DOMJUR | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||