Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06225 | Date 26/08/2019 |
| Token No | SM/19-20/9169 26/08/2019 | Serial | 085 Last Visit: 26/08/2019 |
| Patient Name | Mrs. SHANKARI PAUL | Contact No | 9874890991 |
| Address | 51 CHATRA DHARMOTALA LANE SERAMPORE RATION ID- PHH 0534310948 | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||