Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04772 | Date 20/04/2019 |
| Token No | SM/19-20/1217 20/04/2019 | Serial | 038 Last Visit: 20/04/2019 |
| Patient Name | Mrs. SUSHAMA SANTRA | Contact No | |
| Address | 34 BHADURI PARA SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||