Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01290 | Date 24/09/2018 |
| Token No | SM/18-19/2585 06/10/2018 | Serial | 045 Last Visit: 06/10/2018 |
| Patient Name | Mrs. SANTANA DUTTA | Contact No | |
| Address | 17 ROY M C LEHIRI STREET | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||