Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05285 | Date 29/05/2019 |
| Token No | SM/19-20/3659 29/05/2019 | Serial | 026 Last Visit: 29/05/2019 |
| Patient Name | Mrs. KRISHNA BANERJEE | Contact No | 9231936417 |
| Address | 16/2 CHATRA MUKHERJEE PARA SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||