Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00500 | Date 17/08/2018 |
| Token No | SM/18-19/6175 03/01/2019 | Serial | 012 Last Visit: 27/12/2021 |
| Patient Name | Mrs. ANILA DAS | Contact No | 9874038354 |
| Address | 63, CHATRA DHARMOTALA SERAMPORE | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||