Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04936 | Date 27/04/2019 |
| Token No | SM/19-20/1778 27/04/2019 | Serial | 027 Last Visit: 10/05/2019 |
| Patient Name | Mrs. PIYALI ADHIKARY | Contact No | 9804194353 |
| Address | 13/2 CHATRA CHOWDHURY PARA LANE SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||