Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02680 | Date 24/12/2018 |
| Token No | SM/18-19/5737 24/12/2018 | Serial | 060 Last Visit: 24/12/2018 |
| Patient Name | Mrs. PRATIBHA DAS | Contact No | 9874011519 |
| Address | 19, BHADURI LANE SERAMPORE | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||