Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02737 | Date 29/12/2018 |
| Token No | SM/18-19/5973 29/12/2018 | Serial | 028 Last Visit: 31/12/2018 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 8276929188 |
| Address | PAMPA NAGAR SERAMPORE | Age | 23 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||