Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06564 | Date 27/09/2019 |
| Token No | SM/20-21/29014 05/01/2021 | Serial | 030 Last Visit: 05/01/2021 |
| Patient Name | Mrs. ESHA GUHA | Contact No | 9433128053 |
| Address | 8A CHOWDHURI PARA BAI LANE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||