Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01936 | Date 12/11/2018 |
| Token No | SM/18-19/3577 12/11/2018 | Serial | 055 Last Visit: 12/11/2018 |
| Patient Name | Mrs. GITI BANERJEE | Contact No | 7890035144 |
| Address | CHATRA CHOWDHURY PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||