Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05473 | Date 18/06/2019 |
| Token No | SM/19-20/4810 18/06/2019 | Serial | 068 Last Visit: 18/06/2019 |
| Patient Name | Mrs. SINDHUBALA SADHUKHAN | Contact No | 9681065397 |
| Address | KONNAGAR BASAI | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||