Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09112 | Date 30/12/2020 |
| Token No | SM/20-21/28902 30/12/2020 | Serial | 007 Last Visit: 30/12/2020 |
| Patient Name | Mrs. PIYALI CHOWDHURY | Contact No | 8697524249 |
| Address | 40/A CHATRA MUKHERJEE PARA , BAIDYABATI, CHATRA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||