Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 01366 | Date 27/09/2018 |
| Token No | SM/18-19/2128 27/09/2018 | Serial | 009 Last Visit: 27/09/2018 |
| Patient Name | Mrs. MEHRUN NESA | Contact No | |
| Address | 4, K.M BHATCHARYA STREET SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||