Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00489 | Date 16/08/2018 |
| Token No | SM/18-19/7981 04/02/2019 | Serial | 077 Last Visit: 04/02/2019 |
| Patient Name | Mrs. MAMTA GANGPUTRA | Contact No | 8481841790 |
| Address | 85, A.P GHOSH ROAD | Age | 19.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||