Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03399 | Date 06/02/2019 |
| Token No | SM/19-20/11855 16/10/2019 | Serial | 073 Last Visit: 07/11/2019 |
| Patient Name | Mrs. MITALI SAMANTA | Contact No | 8420776050 |
| Address | 36/C A.P GHOSH ROAD CHATRA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||