Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05729 | Date 11/07/2019 |
| Token No | SM/19-20/6265 11/07/2019 | Serial | 015 Last Visit: 11/07/2019 |
| Patient Name | Mrs. ALO MONDAL | Contact No | |
| Address | 30 A CHAKRABORTY LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||