Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00570 | Date 20/08/2018 |
| Token No | SM/19-20/11798 16/10/2019 | Serial | 016 Last Visit: 06/03/2020 |
| Patient Name | Mrs. LINA GHOSH | Contact No | 8017032850 |
| Address | 11 DR. P.N. MUKHERJEE STREET CHATRA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||