Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00820 | Date 29/08/2018 |
| Token No | SM/18-19/11479 28/03/2019 | Serial | 081 Last Visit: 28/03/2019 |
| Patient Name | Mrs. GITA DAS | Contact No | 8777693276 |
| Address | 146/2 SERAMPORE MAHESH COLLNEY | Age | 46 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||