Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04087 | Date 08/03/2019 |
| Token No | SM/19-20/23000 12/06/2020 | Serial | 006 Last Visit: 11/05/2021 |
| Patient Name | Mrs. JAMUNA MAITY | Contact No | 8100856612 |
| Address | CHATRA MANNA PARA RAMKRISHANA ROAD, BAIDYABATI(M) | Age | 75 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||