Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01432 | Date 29/09/2018 |
| Token No | SM/18-19/2269 29/09/2018 | Serial | 057 Last Visit: 29/09/2018 |
| Patient Name | Mrs. DURGA GHOSH | Contact No | 7890054723 |
| Address | 61/A/C GT ROAD PAMPANAGAR BAIDYABATI (M) | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||