Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08874 | Date 15/10/2020 |
| Token No | SM/20-21/26689 15/10/2020 | Serial | 032 Last Visit: 08/01/2021 |
| Patient Name | Mrs. MUNMUN CHATTERJEE | Contact No | 8629906213 |
| Address | N1/7 E.S.I HOSPITAL,MALLICKPARA,BAIDYABATI(M) | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||