Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04965 | Date 29/04/2019 |
| Token No | SM/19-20/2769 15/05/2019 | Serial | 009 Last Visit: 15/05/2019 |
| Patient Name | Mrs. BABY DAS | Contact No | 7044734161 |
| Address | 14 SIDDHESWARI LANE SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||