Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06834 | Date 11/11/2019 |
| Token No | SM/19-20/13030 11/11/2019 | Serial | 072 Last Visit: 27/12/2019 |
| Patient Name | Mrs. SUMITA SADHUKHAN | Contact No | 9051026219 |
| Address | 105 A.P GHOSH ROAD SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||