Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00783 | Date 28/08/2018 |
| Token No | SM/20-21/29048 05/01/2021 | Serial | 064 Last Visit: 02/03/2021 |
| Patient Name | Mrs. CHAMPA SADHUKHAN | Contact No | 9681065397 |
| Address | 40/3 A.P GHOSH ROAD, SERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||