Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01168 | Date 15/09/2018 |
| Token No | SM/18-19/1714 15/09/2018 | Serial | 034 Last Visit: 15/09/2018 |
| Patient Name | Mrs. SRABANTI ROY | Contact No | 8282983422 |
| Address | 2 P.N CHAKRABORTY LANE SERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||