Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05180 | Date 21/05/2019 |
| Token No | SM/19-20/3115 21/05/2019 | Serial | 063 Last Visit: 21/05/2019 |
| Patient Name | Mrs. RITA MONDAL | Contact No | 9339349801 |
| Address | 33D CHATRA BARUI PARA SERAMPORE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||