Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00421 | Date 14/08/2018 |
| Token No | SM/18-19/4271 28/11/2018 | Serial | 003 Last Visit: 21/08/2019 |
| Patient Name | Mrs. SAHELI DUTTA | Contact No | 9874791033 |
| Address | 39, CHATRA DUTTA PARA LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||