Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04001 | Date 05/03/2019 |
| Token No | SM/19-20/11389 01/10/2019 | Serial | 007 Last Visit: 06/10/2020 |
| Patient Name | Mrs. BANDANA CHATERJEE | Contact No | 26522256 |
| Address | 11 JAGAT MOHAN LAHIRI LANE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||