Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02715 | Date 28/12/2018 |
| Token No | SM/18-19/9820 05/03/2019 | Serial | 021 Last Visit: 05/03/2019 |
| Patient Name | Mrs. SIKHA CHAKRABORTY | Contact No | 9051905649 |
| Address | 11 DR. P N MUKHERJEE STREET | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||