Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01255 | Date 22/09/2018 |
| Token No | SM/18-19/1889 22/09/2018 | Serial | 002 Last Visit: 22/09/2018 |
| Patient Name | Mrs. KALAYNI BENERJEE | Contact No | 9339602074 |
| Address | CHATRA DHARMA TALA | Age | 80 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/60 mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||