Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02913 | Date 09/01/2019 |
| Token No | SM/18-19/6932 17/01/2019 | Serial | 012 Last Visit: 17/01/2019 |
| Patient Name | Mrs. BHAROTI SHAW | Contact No | 9874014194 |
| Address | CHATRA MUKHERJEE PARA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||