Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05095 | Date 13/05/2019 |
| Token No | SM/19-20/17247 27/01/2020 | Serial | 042 Last Visit: 04/01/2022 |
| Patient Name | Mrs. TRIPTI DAS | Contact No | 8910502242 |
| Address | 10A BARO BAGAN LANE SERAMPORE MALLICKPARA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||