Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06664 | Date 16/10/2019 |
| Token No | SM/19-20/11883 16/10/2019 | Serial | 101 Last Visit: 18/10/2019 |
| Patient Name | Mrs. DIPTI DUTTA | Contact No | 9748364632 |
| Address | 1 DUTTA PARA LANE CHATRA SERAMPORE | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||