Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03924 | Date 01/03/2019 |
| Token No | SM/18-19/10366 11/03/2019 | Serial | 075 Last Visit: 30/09/2019 |
| Patient Name | Mrs. BASABI MUKHERJEE | Contact No | 9804461084 |
| Address | 90 CHATRA MUKHERJEE PARA, | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||