Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05614 | Date 28/06/2019 |
| Token No | SM/19-20/5542 28/06/2019 | Serial | 046 Last Visit: 28/06/2019 |
| Patient Name | Mrs. SANGITA ROY | Contact No | 9088365636 |
| Address | 66 HATTACHARJEE GARDEN BYE LANE,BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||