Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10115 | Date 23/09/2021 |
| Token No | SM/21-22/5965 18/10/2021 | Serial | 001 Last Visit: 09/03/2022 |
| Patient Name | Mrs. ASIMA MONDAL | Contact No | 8100381916 |
| Address | 8/E SARAT CHANDRA CHATTAPADHYA SARANI | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||