Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02160 | Date 27/11/2018 |
| Token No | SM/18-19/4252 27/11/2018 | Serial | 044 Last Visit: 27/11/2018 |
| Patient Name | Mrs. JHUMA MUKHERJEE | Contact No | |
| Address | 49 CHATRA SHITALA TALA ROAD,BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||