Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06208 | Date 22/08/2019 |
| Token No | SM/19-20/12039 18/10/2019 | Serial | 059 Last Visit: 06/08/2020 |
| Patient Name | Mrs. KUMKUM DAS | Contact No | 8420352636 |
| Address | 25A DHARMATALA LANE CHATRA SERAMPORE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||