Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06726 | Date 22/10/2019 |
| Token No | SM/19-20/12206 22/10/2019 | Serial | 029 Last Visit: 22/10/2019 |
| Patient Name | Mrs. ANJANA PAL | Contact No | 9674358037 |
| Address | 30/C CHATRA KUMAR PARA SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||