Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02100 | Date 22/11/2018 |
| Token No | SM/18-19/6849 15/01/2019 | Serial | 042 Last Visit: 15/01/2019 |
| Patient Name | Miss MOU BHATTACHARJEE | Contact No | 8013216855 |
| Address | CHATRA DUTTA PARA | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||