Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05848 | Date 19/07/2019 |
| Token No | SM/19-20/6865 19/07/2019 | Serial | 055 Last Visit: 19/07/2019 |
| Patient Name | Mrs. SUMITRA GHOSH | Contact No | 7890807503 |
| Address | 13 N. N. ROY STREET. | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||