Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02125 | Date 26/11/2018 |
| Token No | SM/18-19/4151 26/11/2018 | Serial | 024 Last Visit: 26/11/2018 |
| Patient Name | Mrs. DEBANJONA BANERJEE | Contact No | 9836515118 |
| Address | 18 HORIMOHAN GOSWAMI STREET | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||