Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04517 | Date 02/04/2019 |
| Token No | SM/19-20/127 02/04/2019 | Serial | 065 Last Visit: 02/04/2019 |
| Patient Name | Mrs. DOLLY GHOSH | Contact No | 9331445758 |
| Address | 3 CHATRA DHARMOTALA BYE LANE SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||