Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02884 | Date 07/01/2019 |
| Token No | SM/18-19/6438 07/01/2019 | Serial | 092 Last Visit: 16/08/2019 |
| Patient Name | Mrs. KRISHNA KUNDU | Contact No | 9732111773 |
| Address | 17, CHATRA DUTTA PARA | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||