Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04334 | Date 20/03/2019 |
| Token No | SM/18-19/10992 20/03/2019 | Serial | 097 Last Visit: 05/05/2021 |
| Patient Name | Mrs. PIYALI NANDI | Contact No | 9830453899 |
| Address | 41 CHATRA DUTTA PARA LANE SERAPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||