Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02937 | Date 10/01/2019 |
| Token No | SM/18-19/6585 10/01/2019 | Serial | 012 Last Visit: 10/01/2019 |
| Patient Name | Mrs. KALPANA CHOWDHURY | Contact No | |
| Address | CHATRA BAURIYA PARA,BAIDYABATY(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||