Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09035 | Date 08/12/2020 |
| Token No | SM/20-21/28709 23/12/2020 | Serial | 006 Last Visit: 05/05/2021 |
| Patient Name | Mrs. MOUSUMI BHATTACHARJEE | Contact No | 9836491784 |
| Address | 43 CHAKRABORTY LANE GOSWAMI PARA SERAMPORE | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||