Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04520 | Date 02/04/2019 |
| Token No | SM/19-20/838 12/04/2019 | Serial | 075 Last Visit: 25/05/2019 |
| Patient Name | Miss PRIYA SHAW | Contact No | 6289553399 |
| Address | 281/B/A/1, GHOSAL PARA NABAGRAM, BAIDYABATI(M) | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||