Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03848 | Date 25/02/2019 |
| Token No | SM/18-19/9396 25/02/2019 | Serial | 003 Last Visit: 25/02/2019 |
| Patient Name | Mrs. MADHURI BENERJEE | Contact No | 8697361157 |
| Address | 9 CHATRA CHOWDHURY PARA | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||