Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05728 | Date 11/07/2019 |
| Token No | SM/19-20/7084 23/07/2019 | Serial | 022 Last Visit: 10/08/2019 |
| Patient Name | Mrs. CHAPALA CHATTERJEE | Contact No | 9007601157 |
| Address | 14 CHOWDHURY PARA BYE LANE | Age | 81 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||