Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03826 | Date 23/02/2019 |
| Token No | SM/18-19/9340 23/02/2019 | Serial | 026 Last Visit: 23/02/2019 |
| Patient Name | Mrs. MALATI BISWASH | Contact No | 6290304001 |
| Address | 16/A ROY GHAT LANE | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||