Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04664 | Date 11/04/2019 |
| Token No | SM/19-20/709 11/04/2019 | Serial | 016 Last Visit: 16/11/2021 |
| Patient Name | Mrs. RINA DUTTA | Contact No | 8017495364 |
| Address | 85 SHITLATALA ROAD , BAIDYABATI(M) | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||