Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01950 | Date 14/11/2018 |
| Token No | SM/18-19/3641 14/11/2018 | Serial | 030 Last Visit: 14/11/2018 |
| Patient Name | Mrs. TULI MUKHERJEE | Contact No | 8910081342 |
| Address | 37 A P GHOSH ROAD | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||