Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01795 | Date 31/10/2018 |
| Token No | SM/19-20/2500 10/05/2019 | Serial | 097 Last Visit: 10/05/2019 |
| Patient Name | Mrs. BHARATI GHOSH | Contact No | 9051714979 |
| Address | 31 A/1 CHOWDHURI PARA BY LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||