Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07289 | Date 07/01/2020 |
| Token No | SM/19-20/17595 04/02/2020 | Serial | 032 Last Visit: 07/04/2020 |
| Patient Name | Mrs. JAYA CHATTERJEE | Contact No | 9239315470 |
| Address | 11 JAGAMOHAN LAHIRI LANE CHATRA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||