Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09165 | Date 13/01/2021 |
| Token No | SM/20-21/29315 13/01/2021 | Serial | 038 Last Visit: 13/01/2021 |
| Patient Name | Mrs. SHIBANI SARKAR | Contact No | 9230230962 |
| Address | 73/B/M/1 RAMKRISHNA ROAD,BAIDYABATI(M) | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||