Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04175 | Date 11/03/2019 |
| Token No | SM/18-19/11197 25/03/2019 | Serial | 117 Last Visit: 25/03/2019 |
| Patient Name | Mrs. KANIKA GHOSH | Contact No | 9874759311 |
| Address | 6/A CHATRA GHOSH PARA 1ST LANE SERAMPORE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||