Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03760 | Date 21/02/2019 |
| Token No | SM/18-19/10662 16/03/2019 | Serial | 044 Last Visit: 26/08/2019 |
| Patient Name | Mrs. SUMITA MUKHERJEE | Contact No | 9051573876 |
| Address | 10A VIVEKANAND LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||