Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06596 | Date 05/10/2019 |
| Token No | SM/19-20/11512 05/10/2019 | Serial | 002 Last Visit: 05/10/2019 |
| Patient Name | Miss SOMAIYA | Contact No | |
| Address | CHATRA MUSALMAN PARA , SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||