Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04799 | Date 22/04/2019 |
| Token No | SM/19-20/1299 22/04/2019 | Serial | 014 Last Visit: 30/07/2019 |
| Patient Name | Mrs. SHANTANA CHATTOPADHYAY | Contact No | 9051450029 |
| Address | 135 CHATRA BARUI PARA LANE 2 SERAMPORE | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||