Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04661 | Date 10/04/2019 |
| Token No | SM/19-20/683 10/04/2019 | Serial | 049 Last Visit: 28/05/2019 |
| Patient Name | Mrs. NAMITA PAL | Contact No | 9903165351 |
| Address | 27 A CHATRA KUMER PARA | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||