Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05125 | Date 15/05/2019 |
| Token No | SM/19-20/2824 15/05/2019 | Serial | 064 Last Visit: 15/05/2019 |
| Patient Name | Mrs. GITA ADHIKARY | Contact No | 8481803265 |
| Address | 13/2 CHATRA CHOWDHURY PARA LANE SERAMPORE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||