Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05175 | Date 21/05/2019 |
| Token No | SM/19-20/3393 25/05/2019 | Serial | 019 Last Visit: 25/05/2019 |
| Patient Name | Mrs. RUMKI GUIN | Contact No | 9748380781 |
| Address | 90/2 CHATRA BARUI APRA PARA SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||