Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04946 | Date 27/04/2019 |
| Token No | SM/19-20/5222 24/06/2019 | Serial | 088 Last Visit: 24/06/2019 |
| Patient Name | Mrs. SIMA BAG | Contact No | 9432401349 |
| Address | 13B GHOSH PARA 1ST LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||