Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03717 | Date 20/02/2019 |
| Token No | SM/18-19/9082 20/02/2019 | Serial | 020 Last Visit: 29/09/2022 |
| Patient Name | Miss DIPIKA MAITY | Contact No | 9804893541 |
| Address | 41 RAMKRISHANA ROAD CHATRA SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||