Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06930 | Date 20/11/2019 |
| Token No | SM/19-20/14310 29/11/2019 | Serial | 079 Last Visit: 07/05/2021 |
| Patient Name | Mrs. GITA LAHIRI | Contact No | 8697928095 |
| Address | 5 P.N MUKHERJEE STREET SERAMPORE | Age | 74 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||