Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04802 | Date 22/04/2019 |
| Token No | SM/19-20/2409 10/05/2019 | Serial | 006 Last Visit: 25/02/2020 |
| Patient Name | Mrs. SUPARNA SOM | Contact No | 9830716993 |
| Address | 17/D CHATRA DUTTA PARA SERAMPORE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||