Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03429 | Date 07/02/2019 |
| Token No | SM/18-19/8216 07/02/2019 | Serial | 043 Last Visit: 08/03/2019 |
| Patient Name | Mrs. PURNIMA GHOSH | Contact No | |
| Address | 2 RAMKRISHNA BY LANE,BAIDYABATI(M) | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||