Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02747 | Date 31/12/2018 |
| Token No | SM/18-19/6006 31/12/2018 | Serial | 005 Last Visit: 31/12/2018 |
| Patient Name | Mrs. SUKLA LAHA | Contact No | 9836099712 |
| Address | BHATTCHARJEE GARDEN NOGA, BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||