Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06686 | Date 18/10/2019 |
| Token No | SM/19-20/12014 18/10/2019 | Serial | 034 Last Visit: 18/10/2019 |
| Patient Name | Mrs. UMARANI GHOSH | Contact No | 9903140777 |
| Address | 52/25 RAM KRISHNA ROAD,BAIDYABATI(M) | Age | 78 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||