Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05176 | Date 21/05/2019 |
| Token No | SM/21-22/3370 22/07/2021 | Serial | 047 Last Visit: 22/07/2021 |
| Patient Name | Mrs. DEBJANI SANYAL | Contact No | 8584034140 |
| Address | 7/A DR, G.C GOSWAMI STREET , BACK SIDE OF MITALI SANGHA CLUB SERAMPORE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||