Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06545 | Date 26/09/2019 |
| Token No | SM/19-20/11131 26/09/2019 | Serial | 015 Last Visit: 26/09/2019 |
| Patient Name | Mrs. SOUMITA ROY | Contact No | |
| Address | 55/B BOROBAGAN LANE | Age | 28 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||