Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03612 | Date 16/02/2019 |
| Token No | SM/19-20/4670 15/06/2019 | Serial | 053 Last Visit: 26/09/2019 |
| Patient Name | Mrs. NABANITA HALDAR | Contact No | 9674513499 |
| Address | CHATRA 20 P.N BANERJEE ROAD | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||