Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07251 | Date 30/12/2019 |
| Token No | SM/20-21/27378 10/11/2020 | Serial | 019 Last Visit: 17/01/2022 |
| Patient Name | Mrs. RINA BANERJEE | Contact No | 9874180133 |
| Address | 35/A DHARMATALA LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||