Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05212 | Date 23/05/2019 |
| Token No | SM/19-20/3307 23/05/2019 | Serial | 055 Last Visit: 05/12/2019 |
| Patient Name | Mrs. PUSPA RANI PAL | Contact No | 9674347110 |
| Address | 16A/1 CHATRA BARUI PARA LANE SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||