Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04923 | Date 26/04/2019 |
| Token No | SM/19-20/1719 26/04/2019 | Serial | 031 Last Visit: 26/04/2019 |
| Patient Name | Mrs. RIYA ADHIKARY | Contact No | 8240551634 |
| Address | 28, KSHUDIRAM BOSE ROAD BARA BAHERA, UTTARPARA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||