Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09176 | Date 15/01/2021 |
| Token No | SM/20-21/29401 15/01/2021 | Serial | 034 Last Visit: 22/01/2021 |
| Patient Name | Miss REKHA DEY | Contact No | 8697462911 |
| Address | 8/A CHATRA CHOWDHURY PARA (DOL TALA), SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||