Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06963 | Date 23/11/2019 |
| Token No | SM/19-20/13822 23/11/2019 | Serial | 017 Last Visit: 23/11/2019 |
| Patient Name | Mrs. KALYANI SARDAR | Contact No | 9748508092 |
| Address | 143/A BHATTACHARJEE GARDEN BYE LANE , NABAGRAM BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||