Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00729 | Date 27/08/2018 |
| Token No | SM/18-19/1158 01/09/2018 | Serial | 032 Last Visit: 01/09/2018 |
| Patient Name | Mrs. BIJAYA MITRA | Contact No | |
| Address | 10/G/1 ROY M.C LAHIRI BHADUR STREET | Age | 50.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||