Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03790 | Date 22/02/2019 |
| Token No | SM/18-19/10041 07/03/2019 | Serial | 044 Last Visit: 24/12/2019 |
| Patient Name | Mrs. MAYA BANERJEE | Contact No | 9883913151 |
| Address | 1 CHATRA GHOSH PARA SERAMPORE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||