Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08346 | Date 13/06/2020 |
| Token No | SM/19-20/23063 13/06/2020 | Serial | 022 Last Visit: 13/06/2020 |
| Patient Name | Mrs. BAISHAKHI SARKAR | Contact No | 8013392789 |
| Address | 16/1 K.C MUKHERJEE STREET CHATRA SERAMPORE , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||