Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 02816 | Date 04/01/2019 |
| Token No | SM/19-20/12252 22/10/2019 | Serial | 075 Last Visit: 11/11/2020 |
| Patient Name | Mrs. PRITIKANA CHAKRABORTY | Contact No | 8017162926 |
| Address | SEORAPHULY, MALLICK BAGAN, BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||