Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03609 | Date 16/02/2019 |
| Token No | SM/19-20/10138 11/09/2019 | Serial | 045 Last Visit: 11/09/2019 |
| Patient Name | Mrs. LILABATI GHOSH | Contact No | 9073223220 |
| Address | 3 CHATRA DHARMA TALA BY LANE, | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||