Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07873 | Date 20/03/2020 |
| Token No | SM/19-20/20027 20/03/2020 | Serial | 064 Last Visit: 04/08/2021 |
| Patient Name | Mrs. SUTAPA MODAK | Contact No | 7278138862 |
| Address | 53 A.P. GHOSH ROAD CHATRA SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||