Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03353 | Date 04/02/2019 |
| Token No | SM/19-20/12002 18/10/2019 | Serial | 022 Last Visit: 06/12/2019 |
| Patient Name | Mrs. BAISALI DUTTA | Contact No | 9836811461 |
| Address | 83/A MALLIK PARA LANE,SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||