Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01232 | Date 19/09/2018 |
| Token No | SM/18-19/9655 01/03/2019 | Serial | 030 Last Visit: 26/08/2019 |
| Patient Name | Mrs. SANDHYA CHATERJEE | Contact No | 8100112891 |
| Address | 8, MUSALMAN PARA ROAD | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||