Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04339 | Date 23/03/2019 |
| Token No | SM/18-19/11572 29/03/2019 | Serial | 080 Last Visit: 17/07/2019 |
| Patient Name | Mrs. SANTA MUKHERJEE | Contact No | 9674806109 |
| Address | 40 K.C MUKHERJEE STREET , BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||