Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03856 | Date 25/02/2019 |
| Token No | SM/18-19/10968 20/03/2019 | Serial | 073 Last Visit: 02/04/2019 |
| Patient Name | Mrs. CHABI MAITY | Contact No | 8335891656 |
| Address | RAMKRISHNA ROAD,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||