Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02586 | Date 18/12/2018 |
| Token No | SM/19-20/6319 11/07/2019 | Serial | 069 Last Visit: 11/07/2019 |
| Patient Name | Miss RIYA GHOSH | Contact No | 9875442744 |
| Address | 18 BENIYA PARA LANE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||