Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00834 | Date 30/08/2018 |
| Token No | SM/18-19/2574 06/10/2018 | Serial | 034 Last Visit: 17/04/2019 |
| Patient Name | Mrs. GITA KARMOKAR | Contact No | 8334942430 |
| Address | 85, A.P GHOSH ROAD | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||