Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08435 | Date 26/06/2020 |
| Token No | SM/19-20/23868 07/07/2020 | Serial | 033 Last Visit: 03/05/2021 |
| Patient Name | Mrs. SUSAMA DAS | Contact No | |
| Address | 32 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||