Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03796 | Date 22/02/2019 |
| Token No | SM/18-19/9279 22/02/2019 | Serial | 056 Last Visit: 22/02/2019 |
| Patient Name | Mrs. CHANDRIMA BANERJEE | Contact No | 7003147729 |
| Address | CHATRA GHOSH PARA 1ST LANE SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||