Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05275 | Date 28/05/2019 |
| Token No | SM/19-20/3623 28/05/2019 | Serial | 064 Last Visit: 28/05/2019 |
| Patient Name | Mrs. ANIMA GUIN | Contact No | 9836582770 |
| Address | 23 DUTTA PARA LANE CHATRA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||