Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07077 | Date 05/12/2019 |
| Token No | SM/19-20/24154 17/07/2020 | Serial | 005 Last Visit: 17/07/2020 |
| Patient Name | Mrs. SHYAMALI BARMAN | Contact No | 9331721026 |
| Address | 18/E CHATRA CHOWDHURY PARA BYE LANE SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||