Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00182 | Date 07/08/2018 |
| Token No | SM/18-19/5451 19/12/2018 | Serial | 015 Last Visit: 08/07/2019 |
| Patient Name | Mrs. RAJARSHI GANGULY | Contact No | 9231478218 |
| Address | 3/E DUTTAPARA LANE, CHATRA | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||