Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05149 | Date 17/05/2019 |
| Token No | SM/19-20/2931 17/05/2019 | Serial | 035 Last Visit: 17/05/2019 |
| Patient Name | Mrs. NAMITA SOM | Contact No | 9674943842 |
| Address | 121 CHATRA BARUI PARA SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||