Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06996 | Date 27/11/2019 |
| Token No | SM/19-20/14106 27/11/2019 | Serial | 015 Last Visit: 27/11/2019 |
| Patient Name | Mrs. SHUKLA CHATERJEE | Contact No | 7602990350 |
| Address | 52 N. C. CHAKRABORTY LANE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||