Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02423 | Date 08/12/2018 |
| Token No | SM/18-19/6762 14/01/2019 | Serial | 053 Last Visit: 14/01/2019 |
| Patient Name | Mrs. KRISHNA MUKHERJEE | Contact No | 9830240734 |
| Address | 63 CHATRA MUKHERJEE PARA | Age | 82 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||