Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05431 | Date 14/06/2019 |
| Token No | SM/19-20/4565 14/06/2019 | Serial | 040 Last Visit: 14/06/2019 |
| Patient Name | Mrs. SHRABANI PAL | Contact No | 9163447373 |
| Address | 50 A.P. GHOSH ROAD SERAMPORE CHATRA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||