Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08965 | Date 11/11/2020 |
| Token No | SM/20-21/27474 11/11/2020 | Serial | 031 Last Visit: 11/11/2020 |
| Patient Name | Mrs. SUCHITRA DAS | Contact No | 6291053875 |
| Address | 15, G T ROAD KALITALA SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||