Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06228 | Date 26/08/2019 |
| Token No | SM/19-20/9183 26/08/2019 | Serial | 099 Last Visit: 26/08/2019 |
| Patient Name | Mrs. JOLLY BANERJEE | Contact No | 9007120874 |
| Address | CHATRA LAHIRI PARA, SERAMPORE | Age | 73 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||