Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02646 | Date 22/12/2018 |
| Token No | SM/18-19/5628 22/12/2018 | Serial | 005 Last Visit: 05/08/2019 |
| Patient Name | Mrs. ALOKA DUTTA | Contact No | 9674497305 |
| Address | 29, CHATRA DUTTA PARA | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||