Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03771 | Date 21/02/2019 |
| Token No | SM/18-19/9201 21/02/2019 | Serial | 063 Last Visit: 21/02/2019 |
| Patient Name | Mrs. BANDANA CHOWDHURY | Contact No | |
| Address | 29/D CHATRA DOLTALA SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||