Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01123 | Date 14/09/2018 |
| Token No | SM/18-19/2185 28/09/2018 | Serial | 014 Last Visit: 27/11/2018 |
| Patient Name | Mrs. MAMATA ROY | Contact No | 9830304219 |
| Address | 1/B/1 DR. P N MUKHARJEE STREET | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||