Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03336 | Date 04/02/2019 |
| Token No | SM/18-19/9033 19/02/2019 | Serial | 063 Last Visit: 10/07/2019 |
| Patient Name | Mrs. MIRA BANERJEE | Contact No | |
| Address | 13 CHATRA DHARMATALA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||