Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06376 | Date 12/09/2019 |
| Token No | SM/19-20/13761 22/11/2019 | Serial | 010 Last Visit: 12/03/2020 |
| Patient Name | Mrs. MANJU ADHIKARY | Contact No | |
| Address | 13 CHATRA CHOWDHURY PARA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||