Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07812 | Date 16/03/2020 |
| Token No | SM/19-20/19731 16/03/2020 | Serial | 055 Last Visit: 23/03/2020 |
| Patient Name | Mrs. UMA PAL | Contact No | 9163511393 |
| Address | 167 VIVEKANAD SARANI SATGOP PARA, BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||