Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02704 | Date 27/12/2018 |
| Token No | SM/18-19/5827 27/12/2018 | Serial | 085 Last Visit: 27/12/2018 |
| Patient Name | Miss SOURI BISWAS | Contact No | 9051786300 |
| Address | SIMLA KALITALA,SARAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||