Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04128 | Date 09/03/2019 |
| Token No | SM/19-20/16077 31/12/2019 | Serial | 019 Last Visit: 09/01/2020 |
| Patient Name | Miss SUSHMITA GHOSAL | Contact No | 9062547077 |
| Address | 24/5 CHATRA GODAR BAGAN LANE , BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||