Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09041 | Date 11/12/2020 |
| Token No | SM/20-21/29264 11/01/2021 | Serial | 026 Last Visit: 11/01/2021 |
| Patient Name | Mrs. KOYEL PAL | Contact No | 7044576211 |
| Address | 18 E BARABAGAN LANE,SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||