Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00784 | Date 28/08/2018 |
| Token No | SM/18-19/9539 27/02/2019 | Serial | 028 Last Visit: 13/08/2024 |
| Patient Name | Mrs. SHAMPA POREL | Contact No | 9883262015 |
| Address | 17, CHAPA TALA LANE | Age | 33 Years,7 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||