Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09084 | Date 22/12/2020 |
| Token No | SM/20-21/28668 22/12/2020 | Serial | 015 Last Visit: 07/01/2021 |
| Patient Name | Mrs. ANJALI MALIK | Contact No | |
| Address | 27/A BARA BAGAN LANE SERAMPORE MALLICKPARA | Age | 43 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||