Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04822 | Date 22/04/2019 |
| Token No | SM/19-20/3001 20/05/2019 | Serial | 049 Last Visit: 20/06/2019 |
| Patient Name | Mrs. JAYA MUKHERJEE | Contact No | 9836908394 |
| Address | 5 NO. CHAPA TALA LANE CHATRA SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||