Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02506 | Date 13/12/2018 |
| Token No | SM/18-19/5184 13/12/2018 | Serial | 031 Last Visit: 13/12/2018 |
| Patient Name | Mrs. ANJALI GHOSH | Contact No | 8513982873 |
| Address | 80 K M SAHA STREET | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||