Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04055 | Date 07/03/2019 |
| Token No | SM/18-19/10042 07/03/2019 | Serial | 045 Last Visit: 07/03/2019 |
| Patient Name | Mrs. JYOTSHNA BANERJEE | Contact No | 9748700761 |
| Address | 7 CHATRA GHOSH PARA 1ST LANE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||