Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06301 | Date 02/09/2019 |
| Token No | SM/19-20/9619 02/09/2019 | Serial | 014 Last Visit: 15/10/2019 |
| Patient Name | Mrs. SUMITA DAS | Contact No | 8100110429 |
| Address | 25 HARIJAN ROAD SERAMPORE ,BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||