Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03242 | Date 31/01/2019 |
| Token No | SM/19-20/16838 18/01/2020 | Serial | 006 Last Visit: 17/05/2022 |
| Patient Name | Miss DEBOLINA BANERJEE | Contact No | 9051887893 |
| Address | 13 DHARMATALA LANE,CHATRA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||