Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09125 | Date 05/01/2021 |
| Token No | SM/20-21/29026 05/01/2021 | Serial | 042 Last Visit: 23/03/2021 |
| Patient Name | Mrs. ASHIMA DEY | Contact No | 8420989823 |
| Address | PAHALMPUR, SINGUR | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||