Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02500 | Date 13/12/2018 |
| Token No | SM/18-19/5168 13/12/2018 | Serial | 015 Last Visit: 29/08/2019 |
| Patient Name | Mrs. SUJATA CHATTERJEE | Contact No | 9674547406 |
| Address | CHATRA SHITALA TALA | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||