Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01860 | Date 02/11/2018 |
| Token No | SM/18-19/3457 05/11/2018 | Serial | 017 Last Visit: 05/11/2018 |
| Patient Name | Mrs. DISA CHATERJEE | Contact No | 9136803599 |
| Address | 10, P.N MUKHERJEE STREET | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||