Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06518 | Date 23/09/2019 |
| Token No | SM/19-20/10969 23/09/2019 | Serial | 096 Last Visit: 23/09/2019 |
| Patient Name | Mrs. BASANTI MALIK | Contact No | 9051902762 |
| Address | 39 A. P. GHOSH ROAD | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||