Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01964 | Date 14/11/2018 |
| Token No | SM/18-19/3686 14/11/2018 | Serial | 075 Last Visit: 14/11/2018 |
| Patient Name | Mrs. MALATI GHOSH | Contact No | 9836083025 |
| Address | 46 24/E GODAR BAGAN LANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||