Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09113 | Date 30/12/2020 |
| Token No | SM/20-21/29548 19/01/2021 | Serial | 042 Last Visit: 18/08/2021 |
| Patient Name | Mrs. RAJPATI DEVI | Contact No | 9477902477 |
| Address | 193//K/C, G T ROAD , BAHIR SERAMPORE NEAR CHARA BAGAN MATH, BAIDYABATI(M) | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||