Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02903 | Date 08/01/2019 |
| Token No | SM/19-20/140 02/04/2019 | Serial | 078 Last Visit: 05/08/2019 |
| Patient Name | Miss DEBIKA BENERJEE | Contact No | 8910424339 |
| Address | 59 DUTTA PARA LANE,CHATRA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||