Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09060 | Date 17/12/2020 |
| Token No | SM/20-21/29179 08/01/2021 | Serial | 017 Last Visit: 08/01/2021 |
| Patient Name | Mrs. SUSMITA DAS MALLICK | Contact No | 8100858120 |
| Address | 3/B S.C CHATTERJEE SARANI MALLICKPARA , SERAMPORE | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||