Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04579 | Date 05/04/2019 |
| Token No | SM/19-20/365 05/04/2019 | Serial | 071 Last Visit: 05/04/2019 |
| Patient Name | Mrs. CHOMPA GHOSH | Contact No | |
| Address | 13 CHATRA GHOSH PARA,SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||