Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04222 | Date 15/03/2019 |
| Token No | SM/19-20/1716 26/04/2019 | Serial | 028 Last Visit: 19/02/2020 |
| Patient Name | Mrs. REKHA GUIN | Contact No | 8013257623 |
| Address | 17 CHATRA DUTTA PARA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||