Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02167 | Date 27/11/2018 |
| Token No | SM/18-19/4268 27/11/2018 | Serial | 060 Last Visit: 27/11/2018 |
| Patient Name | Mrs. SHAMPA SINGH | Contact No | 8910863078 |
| Address | SERAMPORE | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||