Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09137 | Date 07/01/2021 |
| Token No | SM/20-21/29110 07/01/2021 | Serial | 004 Last Visit: 07/01/2021 |
| Patient Name | Miss JAMUNA RAY | Contact No | |
| Address | 33 BARABAGAN LANE,SREAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||