Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 03786 | Date 22/02/2019 |
| Token No | SM/18-19/9257 22/02/2019 | Serial | 034 Last Visit: 22/02/2019 |
| Patient Name | Mrs. MITHU SARKAR | Contact No | 6290370278 |
| Address | 54/A BAG PARA ROAD RISHRA | Age | 37 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||