Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02454 | Date 10/12/2018 |
| Token No | SM/18-19/5020 10/12/2018 | Serial | 068 Last Visit: 19/06/2019 |
| Patient Name | Mrs. SUSHMA CHAKRABORTY | Contact No | |
| Address | 11 P.N MUKHERJEE STREET | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||