Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02829 | Date 04/01/2019 |
| Token No | SM/18-19/6277 04/01/2019 | Serial | 062 Last Visit: 04/01/2019 |
| Patient Name | Mrs. JHUMA GHOSH | Contact No | 9163680812 |
| Address | 8 , A.P GHOSH ROAD | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||