Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02389 | Date 07/12/2018 |
| Token No | SM/18-19/9166 21/02/2019 | Serial | 028 Last Visit: 02/04/2019 |
| Patient Name | Mrs. MIRA GHOSH | Contact No | 9830171243 |
| Address | 6/2 ROY GHAT LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||