Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01397 | Date 28/09/2018 |
| Token No | SM/18-19/2177 28/09/2018 | Serial | 006 Last Visit: 28/09/2018 |
| Patient Name | Mrs. PUSPA MAJHI | Contact No | |
| Address | BENE PARA SERAMPORE HOOGHLY | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/80 mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||