Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02295 | Date 03/12/2018 |
| Token No | SM/19-20/1180 20/04/2019 | Serial | 001 Last Visit: 03/06/2021 |
| Patient Name | Mrs. PHANI BHUSHON DEB | Contact No | 9330829764 |
| Address | 107F/D/A/ G.T ROAD SERAMPORE | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||