Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07702 | Date 04/03/2020 |
| Token No | SM/19-20/19568 13/03/2020 | Serial | 042 Last Visit: 23/03/2020 |
| Patient Name | Mrs. CHAMPA PAL | Contact No | 7044575784 |
| Address | 1 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||