Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02553 | Date 17/12/2018 |
| Token No | SM/18-19/6108 02/01/2019 | Serial | 017 Last Visit: 08/02/2019 |
| Patient Name | Mrs. KALPANA MAITY | Contact No | |
| Address | TARAPUKUR GOV. QUTAER | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||