Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 08880 | Date 16/10/2020 |
| Token No | SM/20-21/26726 16/10/2020 | Serial | 003 Last Visit: 16/10/2020 |
| Patient Name | Mrs. ANIMA CHAKRABORTY | Contact No | 9051153113 |
| Address | 15 GOPIMOHAN SINGHA LANE, BAIDYABATI(M), SHEORAPHULI | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||