Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04879 | Date 24/04/2019 |
| Token No | SM/19-20/4768 18/06/2019 | Serial | 026 Last Visit: 07/08/2019 |
| Patient Name | Mrs. SOMA SOM | Contact No | 9903528997 |
| Address | 124/A/1 CHATRA BARUI PARA LANE SERAMPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||