Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 03730 | Date 20/02/2019 |
| Token No | SM/18-19/9105 20/02/2019 | Serial | 043 Last Visit: 26/08/2020 |
| Patient Name | Mrs. SHANKARI DAS | Contact No | |
| Address | 44/B GANGULY BAGAN LANE MAHESH | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||