Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00589 | Date 20/08/2018 |
| Token No | SM/18-19/8597 13/02/2019 | Serial | 064 Last Visit: 09/04/2019 |
| Patient Name | Mrs. SULACHANA SARKAR | Contact No | 8697075150 |
| Address | SANPUKUR DHAR | Age | 63 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||