Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06240 | Date 27/08/2019 |
| Token No | SM/19-20/9245 27/08/2019 | Serial | 053 Last Visit: 27/08/2019 |
| Patient Name | Mrs. MAMPI BABU SUNIL DAS | Contact No | 9737256884 |
| Address | 22 P N CHAKRABORTY LANE SERAMPORE | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||