Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02468 | Date 11/12/2018 |
| Token No | SM/18-19/5077 11/12/2018 | Serial | 057 Last Visit: 16/01/2019 |
| Patient Name | Mrs. NEEHA GHOSH | Contact No | 9007927899 |
| Address | 15 N N ROY STREET | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||