Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08899 | Date 19/10/2020 |
| Token No | SM/20-21/26901 21/10/2020 | Serial | 031 Last Visit: 21/10/2020 |
| Patient Name | Mrs. NAMITA CHAKRABORTY | Contact No | 8961170850 |
| Address | 41/A L.M. BHATTACHARYA STREET, SERAMPORE, 712201 | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||