Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04317 | Date 20/03/2019 |
| Token No | SM/19-20/852 13/04/2019 | Serial | 012 Last Visit: 21/09/2022 |
| Patient Name | Mrs. KUMKUM CHAKRABORTY | Contact No | 8981501880 |
| Address | 35 (26/1/N) NABIN CHAKRABORTY LANE CHATRA SHITLATALA ,BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||