Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01749 | Date 29/10/2018 |
| Token No | SM/19-20/25436 04/09/2020 | Serial | 007 Last Visit: 12/10/2020 |
| Patient Name | Mrs. ANURUPA MONDAL | Contact No | 8620883589 |
| Address | 11, CHATRA K.C MUKHERJEE ROAD | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||