Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01570 | Date 09/10/2018 |
| Token No | SM/18-19/2623 09/10/2018 | Serial | 012 Last Visit: 09/10/2018 |
| Patient Name | Mrs. SUBARNA BANERJEE | Contact No | |
| Address | 3C DUTTA PARA CHATRA | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||