Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 08764 | Date 21/09/2020 |
| Token No | SM/20-21/28129 04/12/2020 | Serial | 080 Last Visit: 04/12/2020 |
| Patient Name | Mrs. BULA DHAR | Contact No | 9088880204 |
| Address | 40/B G T ROAD WEST SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||