Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08878 | Date 15/10/2020 |
| Token No | SM/20-21/26702 15/10/2020 | Serial | 045 Last Visit: 15/10/2020 |
| Patient Name | Mrs. AMIYA SEN | Contact No | 9073829284 |
| Address | RADHANAGAR SOUTH , BARDDHAMAN , BURDWAN , (SADAR), PURBA BARDHAMAN | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||