Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08741 | Date 15/09/2020 |
| Token No | SM/20-21/25692 15/09/2020 | Serial | 017 Last Visit: 24/09/2020 |
| Patient Name | Mrs. JHARNA SARKAR | Contact No | 9339649156 |
| Address | DAKSHIN RAJYADHARPUR 5 NO COLONI UTTAR RAJYADHARPUR MALLICKPARA SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||