Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03100 | Date 21/01/2019 |
| Token No | SM/19-20/1288 22/04/2019 | Serial | 003 Last Visit: 27/06/2019 |
| Patient Name | Mrs. RITA CHOWDHURY | Contact No | 9088158456 |
| Address | 17 RAMKRISHNA ROAD ,MANNA PARA,BAIDYABATY(M) | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||