Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09097 | Date 26/12/2020 |
| Token No | SM/20-21/28778 26/12/2020 | Serial | 014 Last Visit: 26/12/2020 |
| Patient Name | Mrs. SAROTAWINI DUTTA | Contact No | 9681614678 |
| Address | 54/A CHATRA BARUI PARA LANE SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||