Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06400 | Date 13/09/2019 |
| Token No | SM/19-20/10310 13/09/2019 | Serial | 040 Last Visit: 13/09/2019 |
| Patient Name | Mrs. TARAMANI PAL | Contact No | |
| Address | 5 P.N.K.B LNE CHATRA SERAMPORE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||