Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04993 | Date 02/05/2019 |
| Token No | SM/19-20/2057 02/05/2019 | Serial | 028 Last Visit: 02/05/2019 |
| Patient Name | Mrs. PUSPA RANI PAL | Contact No | 9062236122 |
| Address | 8A/1 CHATRA KUMAR PARA SERAMPORE | Age | 74 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||