Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02578 | Date 18/12/2018 |
| Token No | SM/18-19/5519 20/12/2018 | Serial | 032 Last Visit: 20/12/2018 |
| Patient Name | Mrs. SONIA DAS | Contact No | 9875322980 |
| Address | 5 KOLONI ,SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||