Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09241 | Date 02/02/2021 |
| Token No | SM/20-21/30024 02/02/2021 | Serial | 033 Last Visit: 02/02/2021 |
| Patient Name | Mrs. SUMITRA DUTTA | Contact No | 9687620509 |
| Address | 154/96 CHATRA TETULATALA SHITLATA BAZAR ROAD, BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||