Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07358 | Date 17/01/2020 |
| Token No | SM/19-20/16814 17/01/2020 | Serial | 035 Last Visit: 20/01/2023 |
| Patient Name | Mrs. SAMPA SOM | Contact No | 9330732425 |
| Address | DUTTAS LANE CHATRA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||