Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04770 | Date 20/04/2019 |
| Token No | SM/19-20/1209 20/04/2019 | Serial | 030 Last Visit: 23/04/2019 |
| Patient Name | Mrs. KALPANA DAS | Contact No | 8981564371 |
| Address | 22 PARTIPARA LANE SITLATAL SERAMPORE , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||