Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02752 | Date 31/12/2018 |
| Token No | SM/18-19/6015 31/12/2018 | Serial | 014 Last Visit: 31/12/2018 |
| Patient Name | Mrs. TUMPA MUKHERJEE | Contact No | |
| Address | CHATRA CHOWDHURY PARA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||