Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03478 | Date 09/02/2019 |
| Token No | SM/18-19/8361 09/02/2019 | Serial | 006 Last Visit: 09/02/2019 |
| Patient Name | Mrs. MITHU ROY | Contact No | 9474172792 |
| Address | 2 CHATRA CHOWDHURY PARA SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||