Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05173 | Date 21/05/2019 |
| Token No | SM/19-20/3217 22/05/2019 | Serial | 058 Last Visit: 22/05/2019 |
| Patient Name | Mrs. SEFALI BISWAS | Contact No | 9073229082 |
| Address | 23 ROY GHAT LANE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||