Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04595 | Date 06/04/2019 |
| Token No | SM/19-20/1280 20/04/2019 | Serial | 101 Last Visit: 20/04/2019 |
| Patient Name | Miss SHARMITA SHEE | Contact No | 8647844723 |
| Address | 45A CHATRA BARUI PARA SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||