Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 06693 | Date 19/10/2019 |
| Token No | SM/19-20/12071 19/10/2019 | Serial | 020 Last Visit: 11/12/2019 |
| Patient Name | Mrs. CHANDRABATI PAL | Contact No | 8981349328 |
| Address | 2/C TARA PUKUR COLONY, SERAMPORE , MALLICKPARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||