Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09036 | Date 08/12/2020 |
| Token No | SM/20-21/28242 08/12/2020 | Serial | 027 Last Visit: 08/12/2020 |
| Patient Name | Mrs. MADHABI DAS | Contact No | 9433818593 |
| Address | 42/B BARABAGAN LANE SERAMPORE M | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||