Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03321 | Date 02/02/2019 |
| Token No | SM/18-19/9596 28/02/2019 | Serial | 018 Last Visit: 28/02/2019 |
| Patient Name | Mrs. PURNIMA DEY | Contact No | 9123618568 |
| Address | THAKURBARI STREET | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||