Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02471 | Date 11/12/2018 |
| Token No | SM/18-19/5086 11/12/2018 | Serial | 066 Last Visit: 28/12/2018 |
| Patient Name | Mrs. BHARTI BANERJEE | Contact No | 8013964861 |
| Address | CHATRA PAN PARA BAIDYABATI (M) | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||