Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00815 | Date 29/08/2018 |
| Token No | SM/19-20/20157 23/03/2020 | Serial | 052 Last Visit: 23/03/2020 |
| Patient Name | Mrs. KAJAL BANERJEE | Contact No | 8481954667 |
| Address | BAGER BAGAN CHATRA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||