Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02007 | Date 16/11/2018 |
| Token No | SM/18-19/3807 16/11/2018 | Serial | 040 Last Visit: 27/01/2021 |
| Patient Name | Mrs. DIPA PAL | Contact No | 26527263 |
| Address | 29B P.N MUKHERJEE STREET CHATRA SERAMPORE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||