Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07263 | Date 31/12/2019 |
| Token No | SM/19-20/16103 31/12/2019 | Serial | 045 Last Visit: 31/12/2019 |
| Patient Name | Mrs. CHANDA BEGAM | Contact No | 9748769244 |
| Address | 7A ARBINDA SARANI CHATRA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||