Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01304 | Date 24/09/2018 |
| Token No | SM/18-19/2106 26/09/2018 | Serial | 035 Last Visit: 04/12/2019 |
| Patient Name | Mrs. SANDHYA GHOSH | Contact No | 7003890936 |
| Address | 18, N.N ROY STREET | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||