Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07269 | Date 02/01/2020 |
| Token No | SM/19-20/20978 11/04/2020 | Serial | 001 Last Visit: 19/08/2020 |
| Patient Name | Mrs. NIRMALA PATRA | Contact No | 9748356003 |
| Address | 28 BARO BAGAN LANE SERAMPORE | Age | 98 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||