Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03870 | Date 26/02/2019 |
| Token No | SM/18-19/9483 26/02/2019 | Serial | 036 Last Visit: 07/03/2019 |
| Patient Name | Mrs. SANDHYA RANI CHAKRABORTY | Contact No | 8017225351 |
| Address | 19,CHATRA CHAKRABORTY LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||