Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03901 | Date 27/02/2019 |
| Token No | SM/18-19/10011 07/03/2019 | Serial | 014 Last Visit: 22/03/2021 |
| Patient Name | Mrs. RADHARANI MODAK | Contact No | 8017093407 |
| Address | 54, A.P GHOSH ROAD CHATRA SERAMPORE | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||