Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02068 | Date 20/11/2018 |
| Token No | SM/19-20/7058 22/07/2019 | Serial | 076 Last Visit: 20/03/2020 |
| Patient Name | Mrs. CHINMOY GHOSH | Contact No | 9903140777 |
| Address | 52/25 CHATRA MANA PARA BAIDYABATI (M) | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 87 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||