Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03025 | Date 16/01/2019 |
| Token No | SM/21-22/2455 23/06/2021 | Serial | 009 Last Visit: 28/09/2021 |
| Patient Name | Mrs. SUMITA DAS | Contact No | 9903173783 |
| Address | 3B SIDDHESWARI LANE CHATRA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||