Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04873 | Date 23/04/2019 |
| Token No | SM/19-20/1514 23/04/2019 | Serial | 095 Last Visit: 19/07/2019 |
| Patient Name | Mrs. MIDULA SADHUKHAN | Contact No | 9836534839 |
| Address | 3A CHATRA DHARMOTALA SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||