Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06768 | Date 31/10/2019 |
| Token No | SM/19-20/12516 31/10/2019 | Serial | 037 Last Visit: 06/11/2019 |
| Patient Name | Mrs. SK ASHA BIBI | Contact No | 9903108437 |
| Address | 29 A.K DUTTA SARANI SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||