Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00652 | Date 23/08/2018 |
| Token No | SM/19-20/6782 18/07/2019 | Serial | 057 Last Visit: 03/06/2023 |
| Patient Name | Mrs. SOMA DALAL | Contact No | 8697339708 |
| Address | 82, BARUI PARA LANE CHATRA, SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||