Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09076 | Date 18/12/2020 |
| Token No | SM/20-21/28588 18/12/2020 | Serial | 036 Last Visit: 08/01/2021 |
| Patient Name | Mrs. ARATI SHAW | Contact No | 8917416830 |
| Address | 31 NO GANGULY BAGAN LANE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||