Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02457 | Date 11/12/2018 |
| Token No | SM/18-19/5028 11/12/2018 | Serial | 008 Last Visit: 11/12/2018 |
| Patient Name | Mrs. PUJA GHOSH | Contact No | 8013531994 |
| Address | CHATRA SHITALA TALA,BAIDAYBATY(M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||