Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04756 | Date 18/04/2019 |
| Token No | SM/19-20/2058 02/05/2019 | Serial | 029 Last Visit: 22/06/2019 |
| Patient Name | Mrs. APARNA NAG | Contact No | 8583938121 |
| Address | 29B CHAPA TALA LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||