Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02010 | Date 16/11/2018 |
| Token No | SM/18-19/5200 13/12/2018 | Serial | 047 Last Visit: 28/12/2018 |
| Patient Name | Mrs. RUMKI CHAKRABORTY | Contact No | 9674233548 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI (M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||