Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03165 | Date 24/01/2019 |
| Token No | SM/18-19/7393 24/01/2019 | Serial | 080 Last Visit: 24/01/2019 |
| Patient Name | Mrs. PAPIYA BISWAS | Contact No | 8013700472 |
| Address | 25 CHAKRABORTY LANE SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||