Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09054 | Date 14/12/2020 |
| Token No | SM/20-21/28397 14/12/2020 | Serial | 051 Last Visit: 14/12/2020 |
| Patient Name | Mrs. SAMITA SAHA | Contact No | 8927044821 |
| Address | 46B KUMIR JALA ROAD SERAMPORE | Age | 69 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||