Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02210 | Date 29/11/2018 |
| Token No | SM/18-19/4378 29/11/2018 | Serial | 039 Last Visit: 29/11/2018 |
| Patient Name | Mrs. SOMA DUTTA | Contact No | 8420237056 |
| Address | 12, RABINDO BHAWAN SARANI | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||