Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07618 | Date 24/02/2020 |
| Token No | SM/19-20/18563 24/02/2020 | Serial | 039 Last Visit: 11/03/2020 |
| Patient Name | Mrs. RUPA KARMAKAR | Contact No | 9748417018 |
| Address | 154/83 VIVEKANAND SARANI , SARANI PARA LANE , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||