Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09498 | Date 21/04/2021 |
| Token No | SM/21-22/643 21/04/2021 | Serial | 002 Last Visit: 17/07/2021 |
| Patient Name | Mrs. JHUMA GHOSH | Contact No | 8617272187 |
| Address | 147/55 MUKHERJEE PARA ,HARISABHA CHATRA,,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||