Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02746 | Date 31/12/2018 |
| Token No | SM/18-19/6003 31/12/2018 | Serial | 002 Last Visit: 09/08/2021 |
| Patient Name | Mrs. SHYAMALI DAS | Contact No | 7449927701 |
| Address | CHATRA DAS PARA SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||