Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02647 | Date 22/12/2018 |
| Token No | SM/18-19/5630 22/12/2018 | Serial | 007 Last Visit: 22/12/2018 |
| Patient Name | Mrs. ASTHI CHATERJEE | Contact No | |
| Address | CHATAR BAGER BAGAN , BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||