Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02963 | Date 11/01/2019 |
| Token No | SM/18-19/6682 11/01/2019 | Serial | 039 Last Visit: 21/02/2019 |
| Patient Name | Mrs. RATNA MUKHERJEE | Contact No | 9874991910 |
| Address | 7, PRAN CH. DASA LANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||