Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06413 | Date 14/09/2019 |
| Token No | SM/19-20/10391 14/09/2019 | Serial | 070 Last Visit: 14/09/2019 |
| Patient Name | Mrs. MAYA DAS | Contact No | 9748611575 |
| Address | 17 PNK B LANE CHATRA SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||