Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00034 | Date 01/08/2018 |
| Token No | SM/19-20/25364 03/09/2020 | Serial | 010 Last Visit: 24/05/2021 |
| Patient Name | Mrs. SUSHAMA ASH | Contact No | 9804942280 |
| Address | 11 DUTTAS LANE CHATRA SERAMPORE | Age | 55.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||