Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02962 | Date 11/01/2019 |
| Token No | SM/18-19/6678 11/01/2019 | Serial | 035 Last Visit: 11/01/2019 |
| Patient Name | Miss ARPITA CHOWDHURY | Contact No | 9088405163 |
| Address | 10/C ROY M.C LAHIRI BAHADUR STREET | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||