Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01198 | Date 18/09/2018 |
| Token No | SM/18-19/4704 05/12/2018 | Serial | 028 Last Visit: 27/09/2021 |
| Patient Name | Mrs. JOSHNA SAMANTA | Contact No | 9874325603 |
| Address | 65/20 D.N MUKHERJEE ROAD , BAIDYABATI(M) | Age | 85 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||