Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03136 | Date 22/01/2019 |
| Token No | SM/18-19/7271 22/01/2019 | Serial | 042 Last Visit: 22/04/2019 |
| Patient Name | Miss PUJA GHOSH | Contact No | 9051909645 |
| Address | 31/A/1 CHATRA CHOWDHURY PARA BY LANE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||