Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03700 | Date 19/02/2019 |
| Token No | SM/18-19/9032 19/02/2019 | Serial | 062 Last Visit: 19/02/2019 |
| Patient Name | Mrs. RANI BENERJEE | Contact No | |
| Address | 13 CHATRA DHARMA TALA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||