Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07001 | Date 27/11/2019 |
| Token No | SM/19-20/14164 27/11/2019 | Serial | 073 Last Visit: 27/11/2019 |
| Patient Name | Mrs. CHANDANA GOSWAMI | Contact No | 8240636475 |
| Address | 12/A/1 LAHIRI PARA LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||