Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00214 | Date 07/08/2018 |
| Token No | SM/19-20/3897 03/06/2019 | Serial | 020 Last Visit: 28/07/2020 |
| Patient Name | Mrs. KAKALI DAS | Contact No | 9239879963 |
| Address | 13 RAJA K.L GOSWAMI STREET | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 86.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||