Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01957 | Date 14/11/2018 |
| Token No | SM/18-19/4381 29/11/2018 | Serial | 042 Last Visit: 20/12/2018 |
| Patient Name | Mrs. PRATIMA ROY | Contact No | 9874381659 |
| Address | 6/2 ROY GHAT LANE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 87 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||