Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04105 | Date 09/03/2019 |
| Token No | SM/18-19/10710 18/03/2019 | Serial | 009 Last Visit: 18/03/2019 |
| Patient Name | Mrs. SHAMPA DUTTA | Contact No | 9804417931 |
| Address | 84/A CHATRA BARUI PARA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||