Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09184 | Date 18/01/2021 |
| Token No | SM/20-21/29468 18/01/2021 | Serial | 019 Last Visit: 22/01/2021 |
| Patient Name | Mrs. SUPARNA SADHUKHAN | Contact No | 8961261416 |
| Address | 32/35 KHAS BAGAN LANE BAIDYABATI M | Age | 54 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||