Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07860 | Date 19/03/2020 |
| Token No | SM/20-21/27780 25/11/2020 | Serial | 023 Last Visit: 19/12/2020 |
| Patient Name | Mrs. BHAGARATI GHOSH | Contact No | 9339118246 |
| Address | 43/F CHATRA MUKHERJEE PARA , BARA BAGAN , SHIBTALA , BAIDYABATI(M) | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||