Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01875 | Date 03/11/2018 |
| Token No | SM/19-20/15374 16/12/2019 | Serial | 038 Last Visit: 16/12/2019 |
| Patient Name | Mrs. ARCHANA DAS | Contact No | 8336059957 |
| Address | 4/B P N MUKHARJEE STREET | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||