Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05062 | Date 10/05/2019 |
| Token No | SM/19-20/4952 20/06/2019 | Serial | 092 Last Visit: 20/06/2019 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 8478981233 |
| Address | 5 COLLONY RAJDHARPUR SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||