Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04212 | Date 15/03/2019 |
| Token No | SM/19-20/2433 10/05/2019 | Serial | 030 Last Visit: 14/01/2022 |
| Patient Name | Miss SANGITA PAL | Contact No | 6289686322 |
| Address | 24/A CHATRA KUMAR PARA LANE SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||