Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07097 | Date 06/12/2019 |
| Token No | SM/19-20/14816 06/12/2019 | Serial | 073 Last Visit: 06/12/2019 |
| Patient Name | Mrs. CHUMKI ASH | Contact No | 9903526745 |
| Address | 27/14/1 HARIJAN ROAD SERAMPORE, BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||