Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08620 | Date 04/08/2020 |
| Token No | SM/19-20/24695 04/08/2020 | Serial | 005 Last Visit: 04/08/2020 |
| Patient Name | Mrs. SHANTI DAS | Contact No | |
| Address | GHORAMARA (P) MALLICKPARA, SERAMPORE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||