Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02275 | Date 01/12/2018 |
| Token No | SM/18-19/4516 01/12/2018 | Serial | 043 Last Visit: 01/12/2018 |
| Patient Name | Mrs. SUDIPTA BANERJEE | Contact No | 8017536871 |
| Address | 29A CHATRA BAJAR ROAD | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||