Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05222 | Date 24/05/2019 |
| Token No | SM/19-20/3374 24/05/2019 | Serial | 059 Last Visit: 29/05/2019 |
| Patient Name | Mrs. BITHIKA PYNE | Contact No | |
| Address | 15 BANIYA PARA SERAMPORE | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||