Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01350 | Date 26/09/2018 |
| Token No | SM/18-19/2090 26/09/2018 | Serial | 019 Last Visit: 26/09/2018 |
| Patient Name | Mrs. PAUSHALI PARUI | Contact No | 9051175466 |
| Address | 27/D A.P GHOSH ROAD CHATRA SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||