Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02195 | Date 29/11/2018 |
| Token No | SM/18-19/4346 29/11/2018 | Serial | 007 Last Visit: 13/12/2018 |
| Patient Name | Mrs. PAPIYA BOSE | Contact No | 9331098892 |
| Address | 63B BY SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||