Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00398 | Date 13/08/2018 |
| Token No | SM/18-19/4291 28/11/2018 | Serial | 023 Last Visit: 18/04/2020 |
| Patient Name | Mrs. RENU KHAN | Contact No | 9874769334 |
| Address | 10/Z/A/A, GODARBAGAN BYE LANE, CHATRA, SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||