Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03070 | Date 18/01/2019 |
| Token No | SM/18-19/7045 18/01/2019 | Serial | 049 Last Visit: 18/01/2019 |
| Patient Name | Mrs. NANDA BHATTCHARYYA | Contact No | 8479911797 |
| Address | 58 CHATRA DUTTA PARA | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||