Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01922 | Date 12/11/2018 |
| Token No | SM/18-19/8564 13/02/2019 | Serial | 031 Last Visit: 13/02/2019 |
| Patient Name | Mrs. PARUL BHATTACHARYA | Contact No | |
| Address | 3 DUTTA PARA,CHATRA | Age | 77 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||