Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05065 | Date 10/05/2019 |
| Token No | SM/19-20/2493 10/05/2019 | Serial | 090 Last Visit: 10/05/2019 |
| Patient Name | Mrs. UMA SADHUKHAN | Contact No | 9883051857 |
| Address | 3A DHARMOTALA LANE CHATRA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||