Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02726 | Date 28/12/2018 |
| Token No | SM/18-19/5941 28/12/2018 | Serial | 083 Last Visit: 28/12/2018 |
| Patient Name | Miss RIYA DAS | Contact No | 9748921217 |
| Address | 62/H G T ROAD ,MORADAN,BAIDYABATY(M) | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||