Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04742 | Date 17/04/2019 |
| Token No | SM/19-20/6291 11/07/2019 | Serial | 041 Last Visit: 11/07/2019 |
| Patient Name | Mrs. SUDIPTA DAS (MAITY) | Contact No | 9903607465 |
| Address | 33 BHADURI LANE CHATRA SERAMPORE | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||