Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00415 | Date 13/08/2018 |
| Token No | SM/18-19/5362 17/12/2018 | Serial | 043 Last Visit: 25/04/2019 |
| Patient Name | Mrs. RAMA BANERJEE | Contact No | 9163007121 |
| Address | 29A, MALLICKPARA | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||