Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05564 | Date 25/06/2019 |
| Token No | SM/19-20/7076 23/07/2019 | Serial | 014 Last Visit: 02/08/2019 |
| Patient Name | Mrs. ANITA DAS | Contact No | 9874449059 |
| Address | 30B CHATRA DHARMOTALA LANE SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||