Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02226 | Date 29/11/2018 |
| Token No | SM/18-19/4410 29/11/2018 | Serial | 071 Last Visit: 29/11/2018 |
| Patient Name | Mrs. CHAYA GHOSH | Contact No | 9903140777 |
| Address | CHATRA MANNA PARA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||