Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02863 | Date 07/01/2019 |
| Token No | SM/18-19/7368 24/01/2019 | Serial | 055 Last Visit: 11/07/2019 |
| Patient Name | Mrs. JHARNA MUKHERJEE | Contact No | |
| Address | 7 PISI DAS LANE CHATRA KUMAR PARA | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||