Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06867 | Date 15/11/2019 |
| Token No | SM/19-20/19459 12/03/2020 | Serial | 021 Last Visit: 17/03/2020 |
| Patient Name | Mrs. CHAITALI KARMAKAR CHATTERJEE | Contact No | 9874173896 |
| Address | 8 SIDDESWARI LANE CHATRA SERAMPORE | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||