Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01406 | Date 28/09/2018 |
| Token No | SM/19-20/5382 26/06/2019 | Serial | 046 Last Visit: 26/06/2019 |
| Patient Name | Mrs. MINA RANI KUNDU | Contact No | 9007746625 |
| Address | 473/312 G.T ROAD CHATRA KALI TALA SERAMPORE HOOGHLY | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||