Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06080 | Date 07/08/2019 |
| Token No | SM/19-20/8114 07/08/2019 | Serial | 057 Last Visit: 07/08/2019 |
| Patient Name | Mrs. MANTU GHOSH | Contact No | 8100353832 |
| Address | RAJA K.L GOSWAMI STREET | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||