Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03190 | Date 25/01/2019 |
| Token No | SM/18-19/7474 25/01/2019 | Serial | 064 Last Visit: 25/01/2019 |
| Patient Name | Mrs. RIKA GHOSH | Contact No | 6296302351 |
| Address | 31 A/1 CHATRA CHOWDHURY PARA BY LANE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||