Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05476 | Date 18/06/2019 |
| Token No | SM/19-20/4818 18/06/2019 | Serial | 076 Last Visit: 25/06/2019 |
| Patient Name | Mrs. TUKU MONDAL | Contact No | |
| Address | 51K CHAKRABORTY LANE CHATRA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||