Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02830 | Date 04/01/2019 |
| Token No | SM/18-19/9853 05/03/2019 | Serial | 054 Last Visit: 05/03/2019 |
| Patient Name | Mrs. KRISHNA BANERJEE | Contact No | 7044312886 |
| Address | 8 , A.P GHOSH ROAD | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||