Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05420 | Date 13/06/2019 |
| Token No | SM/19-20/5223 24/06/2019 | Serial | 089 Last Visit: 18/05/2022 |
| Patient Name | Mrs. AVA CHAKRABORTY | Contact No | 9883078020 |
| Address | 6 PN CHAKRABORTY LANE CHATRA SERAMPORE | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||