Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03291 | Date 01/02/2019 |
| Token No | SM/19-20/6302 11/07/2019 | Serial | 052 Last Visit: 16/11/2022 |
| Patient Name | Mrs. DOLLY BENERJEE | Contact No | 8902296891 |
| Address | 85/B KUMIR JELA LANE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||