Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02183 | Date 28/11/2018 |
| Token No | SM/18-19/4311 28/11/2018 | Serial | 043 Last Visit: 28/11/2018 |
| Patient Name | Mrs. RITA MAITRA | Contact No | 8697525593 |
| Address | 5, BURO BIBI LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||