Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04767 | Date 20/04/2019 |
| Token No | SM/19-20/1200 20/04/2019 | Serial | 021 Last Visit: 02/06/2020 |
| Patient Name | Miss MITHU PAL | Contact No | 9748603419 |
| Address | 13/A CHATRA KUMAR PARA SERAMPORE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||