Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05665 | Date 05/07/2019 |
| Token No | SM/19-20/5873 05/07/2019 | Serial | 036 Last Visit: 04/09/2021 |
| Patient Name | Mrs. SHIKHA BERA | Contact No | 8622830918 |
| Address | 14 CHATRA BAZAR ROAD SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||