Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00903 | Date 04/09/2018 |
| Token No | SM/19-20/17506 03/02/2020 | Serial | 036 Last Visit: 16/04/2020 |
| Patient Name | Mrs. SIMA BHUIYA | Contact No | |
| Address | B B GHOSH ROAD, MALLICKPARA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||