Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01108 | Date 13/09/2018 |
| Token No | SM/18-19/8768 15/02/2019 | Serial | 056 Last Visit: 15/02/2019 |
| Patient Name | Mrs. SOMA BANERJEE | Contact No | 9830240498 |
| Address | 29 CHAKRABORTY LANE | Age | 44.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | 120/90 / min | Height | cm BMI: inf |
| Diagnosis | |||