Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03957 | Date 02/03/2019 |
| Token No | SM/21-22/6375 29/10/2021 | Serial | 003 Last Visit: 29/10/2021 |
| Patient Name | Miss MADHUMITA HALDER | Contact No | 8916612974 |
| Address | 133,CHATRA BARUIPARA | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||