Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05333 | Date 03/06/2019 |
| Token No | SM/19-20/3963 03/06/2019 | Serial | 086 Last Visit: 04/06/2019 |
| Patient Name | Mrs. MOUMITA GHOSH | Contact No | 7003937877 |
| Address | 8/A A,P GHOSH ROAD CHATRA SERAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||