Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09172 | Date 15/01/2021 |
| Token No | SM/20-21/29372 15/01/2021 | Serial | 005 Last Visit: 28/01/2021 |
| Patient Name | Mrs. SANDHYARANI DAS | Contact No | 9748347547 |
| Address | 69/2/1 G T ROAD WEST SERAMPORE MALLICKPARA | Age | 71 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||