Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02086 | Date 22/11/2018 |
| Token No | SM/18-19/5139 12/12/2018 | Serial | 053 Last Visit: 12/12/2018 |
| Patient Name | Mrs. DIPTI CHATERJEE | Contact No | |
| Address | 5, CHATRA BAJAR ROAD | Age | 73 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||