Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01697 | Date 27/10/2018 |
| Token No | SM/19-20/11761 15/10/2019 | Serial | 039 Last Visit: 07/09/2021 |
| Patient Name | Miss SHIPRA KARMAKAR | Contact No | 9874518208 |
| Address | 29 RAJA K L GOSWAMI STREET | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||